Resuming Oral Feeding in Patients With Oral Squamous Cell Carcinoma With Free Anterolateral Thigh Flap Reconstruction
| Autor: | Ting-Yen Chiang, Nai-Chen Cheng, Yu-Feng Wu, Chien-Chang Ho, Jung-Hsien Hsieh, Hao-Chih Tai, Ya-Han Yu, Chen-Hsiang Kuan, Shu-Yang Chuang, Chieh-Huei Huang, Shyue-Yih Horng |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Taiwan 030230 surgery Free Tissue Flaps 03 medical and health sciences 0302 clinical medicine Quality of life medicine Humans Basal cell In patient Retrospective Studies business.industry Squamous Cell Carcinoma of Head and Neck Head and neck cancer Significant difference Anterolateral thigh Plastic Surgery Procedures medicine.disease University hospital Surgery Thigh Head and Neck Neoplasms 030220 oncology & carcinogenesis Carcinoma Squamous Cell Quality of Life Mouth Neoplasms business Oral feeding |
| Zdroj: | Annals of plastic surgery. 86(2S Suppl 1) |
| ISSN: | 1536-3708 |
| Popis: | Background Quality of life and functional improvement have emerged as important goals for patients with oncologic disease. For patients with head and neck cancer, free anterolateral thigh (ALT) flaps serve as reliable reconstruction and provide functional restoration. Nevertheless, factors affecting the resumption of oral feeding are rarely described. This study aimed to evaluate and compare the functional outcomes of oral feeding for patients with different oncologic defect patterns and reconstructive ALT flap designs. Methods We retrospectively reviewed patients with head and neck cancer undergoing oncologic ablation and free ALT reconstruction between January 2016 and April 2018 at National Taiwan University Hospital. Patients were categorized into 2 groups as through-and-through (T&T) and non-through-and-through (non-T&T) according to the defect pattern. We further subgrouped T&T patients into lip resection/lip sparing according to lip involvement. Reconstructive ALT flaps were of 2 designs, folded (F-ALT) and chimeric (C-ALT). Outcomes of oral feeding were analyzed using descriptive statistics, and differences between groups were compared using the Student t test. Results We identified 233 patients who received oncologic ablation and free ALT flap reconstruction. There was no significant difference in functional recovery between the T&T and non-T&T groups (81.2% vs 73%, P = 0.137). However, among patients who succeeded in resuming oral feeding, lip-sparing patients had better functional recovery in terms of early oral feeding within 6 months and nasogastric tube removal compared with lip-resection patients (100% vs 83.3%, P = 0.001). Moreover, the F-ALT design resulted in a higher success rate in resuming oral feeding compared with the C-ALT design (90.5% vs 54.6%, P = 0.032). Conclusions Patients with head and neck cancer with T&T defects were associated with higher rates of secondary flap revision and a trend of delayed oral feeding. In the long term, improved oral feeding outcome with the F-ALT design was observed compared with the C-ALT design in the specific group with T&T defect. |
| Databáze: | OpenAIRE |
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