Phẫu thuật ung thư khoang miệng có tạo hình khuyết hổng bằng vạt dưới cằm

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Tác giả: Thị Vân Thảo Lương, Tựu Nguyễn, Xuân Hùng Nguyễn, Hữu Phúc Trần, Nhật Huy Trần, Thế Nam An Võ

Ngôn ngữ: Vie

Ký hiệu phân loại: 616.994 +Cancers

Thông tin xuất bản: Tạp chí Y học lâm sàng, 2021

Mô tả vật lý: 121-126

Bộ sưu tập: Metadata

ID: 411207

Thêm vào giỏ Liên kết toàn văn

Ung thư khoang miệng chiếm tỷ lệ 30% ung thư đầu cổ và 2.0% trong ung thư nói chung. Phẫu thuật phải đảm bảo cắt rộng u với diện cắt an toàn để hạn chế tái phát, nhưng thường để lại khuyết hổng khá lớn. Vạt dưới cằm được sử dụng rộng rãi trong tạo hình khuyết hổng vùng khoang miệng, có đặc điểm: tỷ lệ sống cao, linh hoạt. Nghiên cứu này nhằm đánh giá hiệu quả của vạt dưới cằm trong tạo hình khuyết hổng sau cắt ung thư khoang miệng tại khoa Phẫu Thuật - Trung tâm Ung Bướu - Bệnh viện Trung Ương Huế từ tháng 4/2020 - 8/2021. Đây là nghiên cứu tiến cứu can thiệp lâm sàng không nhóm chứng trên 8 trường hợp sử dụng vạt dưới cằm trong tạo hình khuyết hổng sau cắt ung thư khoang miêng. Kích thước vạt trung bình là 28 cm2 (4 x 7 cm), tái tao khuyết hổng vùng lưỡi 3 trường hợp, lưỡi sàn miệng 4 trường hợp, niêm mạc má và góc hậu hàm 1 trường hợp. Bệnh nhân được ăn qua đường miệng sau 8 ngày, xuất viện sau 12 ngày. Biến chứng: Rò miệng - cổ 2 trường hợp, hoại tử 1 phần vạt: 1 trường hợp. Sau 1 tháng, các vạt lành tốt, chức năng khoang miệng ảnh hưởng ít (chức năng nhai nuốt và phát âm ảnh hưởng ít). Sau 6 tháng, ghi nhận 7/8 trường hợp không tái phát tại chỗ, các vạt lành tốt, chức năng khoang miệng bình thường, 1 trường hợp tái phát tại chỗ. Vạt dưới cằm có tỷ lệ sống cao hỗ trợ lấp khuyết hổng vùng khoang miệng., Tóm tắt tiếng anh, Globally, oral cancer accounts for 30% of head and neck cancers and 2.0% of all cancer. The surgery must remove the tumor with safe marginal resection to limit recurrence however, it causes large defects. The submental flap is gaining popularity as a technique for reconstructing oral defects, with advantages: high survival rate and flexibility. This study aimsto evaluate the efficacy of the submental flap in reconstructive defects after oral cancer surgery at the Department of Oncology Surgery - Oncology Center of Hue Central Hospital from April 2020 to August 2021. A prospective study was conducted on 8 patients who had defects reconstructed by a submental flap after oral cancer surgery. The average dimension of the submental flap was 28 cm2 (4 x 7 cm). The reconstructed sites included: tongue (3 cases), floor of mouth (4 cases), buccal mucosa (1 case). Patients had oral feeds after 8 days, discharged after 12 days. Complications: Oro - cutaneous fistula (2 cases), partial necrosis (1 case). After one month, the flaps were survival, and the oral cavity function had reduced (swallowing and speech function were quite limited). After six months, 7/8 cases had no locoregional recurrence the flap was good, and the oral cavity function was normal. One case had local recurrence.Conclusions: Submental flap is a valid option for reconstructing intra - oral soft tissue with a high survival rate.

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