Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity
The study objective is to assess immediate and long-term results of replacing complex defects with a free radial forearm flap in the multimodal treatment of patients with locally advanced oral cavity squamous cell carcinoma. Materials and methods. Twenty eight patients (20 women and 8 men aged 23 to...
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| Format: | Article |
| Language: | Russian |
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ABV-press
2020-04-01
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| Series: | Опухоли головы и шеи |
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| Online Access: | https://ogsh.abvpress.ru/jour/article/view/476 |
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| author | H. Chen A. M. Mudunov R. I. Azizian I. N. Pustynskiy O. A. Saprina M. V. Bolotin |
| author_facet | H. Chen A. M. Mudunov R. I. Azizian I. N. Pustynskiy O. A. Saprina M. V. Bolotin |
| author_sort | H. Chen |
| collection | DOAJ |
| description | The study objective is to assess immediate and long-term results of replacing complex defects with a free radial forearm flap in the multimodal treatment of patients with locally advanced oral cavity squamous cell carcinoma. Materials and methods. Twenty eight patients (20 women and 8 men aged 23 to 71 years) with locally advanced oral cavity squamous cell carcinoma (including 10 buccal cancers, 8 carcinomas of tongue, 6 carcinomas of the floor of the mouth, 2 retromolar area carcinomas, 1 carcinoma of the hard palate and 1 carcinoma of alveolar region of the lower jaw) underwent tumor surgery with simultaneous plastic reconstruction of the defect using radial forearm free flap at the department of head and neck tumors of N. N. Blokhin National Medical Research Center of Oncology within 2010–2018. Primary tumors were detected in 2 patients and 11 patients had residual (n = 7) or recurrent (n = 4) tumors after radiotherapy or chemoradiotherapy. Results. An overall success rate was 96.4 %. Postoperative histology revealed that there were no tumor cells at the resection edges. Postoperative complications included: complete flap necrosis in 1 patient with severe concomitant diseases, marginal flap necrosis in 2 patients (in both cases after the necrotic tissue had rejected, wounds were healed by secondary intention), sural veins thrombosis in 1 patient, acute peptic ulcer bleeding on the 6th day after surgery in 1 patient treated with emergency endoscopic hemostasis. No lethal outcomes were reported. Postoperative period lasted in average 14 days. Upon subsequent observation tumor relapse in the oral cavity occurred in 4 (14.3 %) patients, relapses of regional metastases – in 2 (7.1 %). Good aesthetic and functional results were noted. Adequate restoration of breathing, chewing, swallowing and speaking resulted in a full patients’ rehabilitation. In all cases, the radial flap adapted well to the oral cavity organs and corresponded to the surrounding tissues in thickness and consistency. Conclusion. Use of a radial forearm free flap makes it possible to successfully reconstruct extensive and complex defects after surgery of locally advanced primary and recurrent forms of oral cavity squamous cell cancer of various locations. Due to flap’s high regenerative capabilities, preoperative radiation therapy does not affect the frequency of local complications. It allows restoring vital functions of the oral cavity and achieving good aesthetic and functional results. |
| format | Article |
| id | doaj-art-15ccbcdc031a4982908fa4fc9c292b45 |
| institution | Kabale University |
| issn | 2222-1468 2411-4634 |
| language | Russian |
| publishDate | 2020-04-01 |
| publisher | ABV-press |
| record_format | Article |
| series | Опухоли головы и шеи |
| spelling | doaj-art-15ccbcdc031a4982908fa4fc9c292b452025-08-20T03:59:48ZrusABV-pressОпухоли головы и шеи2222-14682411-46342020-04-01101556410.17650/2222-1468-2020-10-1-55-64382Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavityH. Chen0A. M. Mudunov1R. I. Azizian2I. N. Pustynskiy3O. A. Saprina4M. V. Bolotin5I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaThe study objective is to assess immediate and long-term results of replacing complex defects with a free radial forearm flap in the multimodal treatment of patients with locally advanced oral cavity squamous cell carcinoma. Materials and methods. Twenty eight patients (20 women and 8 men aged 23 to 71 years) with locally advanced oral cavity squamous cell carcinoma (including 10 buccal cancers, 8 carcinomas of tongue, 6 carcinomas of the floor of the mouth, 2 retromolar area carcinomas, 1 carcinoma of the hard palate and 1 carcinoma of alveolar region of the lower jaw) underwent tumor surgery with simultaneous plastic reconstruction of the defect using radial forearm free flap at the department of head and neck tumors of N. N. Blokhin National Medical Research Center of Oncology within 2010–2018. Primary tumors were detected in 2 patients and 11 patients had residual (n = 7) or recurrent (n = 4) tumors after radiotherapy or chemoradiotherapy. Results. An overall success rate was 96.4 %. Postoperative histology revealed that there were no tumor cells at the resection edges. Postoperative complications included: complete flap necrosis in 1 patient with severe concomitant diseases, marginal flap necrosis in 2 patients (in both cases after the necrotic tissue had rejected, wounds were healed by secondary intention), sural veins thrombosis in 1 patient, acute peptic ulcer bleeding on the 6th day after surgery in 1 patient treated with emergency endoscopic hemostasis. No lethal outcomes were reported. Postoperative period lasted in average 14 days. Upon subsequent observation tumor relapse in the oral cavity occurred in 4 (14.3 %) patients, relapses of regional metastases – in 2 (7.1 %). Good aesthetic and functional results were noted. Adequate restoration of breathing, chewing, swallowing and speaking resulted in a full patients’ rehabilitation. In all cases, the radial flap adapted well to the oral cavity organs and corresponded to the surrounding tissues in thickness and consistency. Conclusion. Use of a radial forearm free flap makes it possible to successfully reconstruct extensive and complex defects after surgery of locally advanced primary and recurrent forms of oral cavity squamous cell cancer of various locations. Due to flap’s high regenerative capabilities, preoperative radiation therapy does not affect the frequency of local complications. It allows restoring vital functions of the oral cavity and achieving good aesthetic and functional results.https://ogsh.abvpress.ru/jour/article/view/476oral cavity squamous cell cancer, surgery, reconstruction, radial flap, long-term results, complications |
| spellingShingle | H. Chen A. M. Mudunov R. I. Azizian I. N. Pustynskiy O. A. Saprina M. V. Bolotin Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity Опухоли головы и шеи oral cavity squamous cell cancer, surgery, reconstruction, radial flap, long-term results, complications |
| title | Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity |
| title_full | Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity |
| title_fullStr | Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity |
| title_full_unstemmed | Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity |
| title_short | Free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally-advanced squamous cell carcinoma of the oral cavity |
| title_sort | free radial forearm flap for reconstruction of postoperative defects in combined and complex treatment of patients with locally advanced squamous cell carcinoma of the oral cavity |
| topic | oral cavity squamous cell cancer, surgery, reconstruction, radial flap, long-term results, complications |
| url | https://ogsh.abvpress.ru/jour/article/view/476 |
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