Kết quả bước đầu điều trị bổ trợ Capecitabine trên bệnh nhân ung thư vòm giai đoạn III-IVa sau hoá xạ đồng thời=Island pedicle nasolabial flap for reconstruction following facial skin cancer resection

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hùng Kiên Đỗ, Văn Tài Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.52-59

Bộ sưu tập: Metadata

ID: 478114

Thêm vào giỏ

Đánh giá kết quả quả ứng dụng vạt đảo mũi má trong tái tạo khuyết hổng sau phẫu thuật ung thư da mặt Đối tượng - phương pháp: Nghiên cứu mô tả tiến cứu 32 bệnh nhân ung thư da mặt được phẫu thuật cắt rộng bướu, tái tạo khuyết hổng bằng vạt đảo mũi má tại bệnh viện Ung Bướu Thành phố Hồ Chí Minh từ 01/2021 đến 10/2022 Kết quả: Chúng tôi sử dụng 32 vạt đảo mũi má tạo hình khuyết hổng vùng mặt sau phẫu thuật cắt rộng ung thư da mặt. Tỷ lệ nam/nữ là 1,46. Tuổi trung bình là 65,7 tuổi (46-92 tuổi). Carcinôm tế bào đáy là 71,9% và carcinôm tế bào gai là 28,1%. Giai đoạn bướu T2 - T3 chiếm ưu thế với 65,7% và T4 chiếm 12,5%. Chủ yếu là dạng khuyết hổng phức tạp, tỷ lệ 59,4%. Kích thước vạt lớn nhất là 6,5cm x 8cm (trung bình: 3,5cm x 6cm). Thời gian theo dõi sau điều trị là 3-22 tháng (trung bình 6 tháng), ghi nhận 1 trường hợp tái phát (3,1%). Tỷ lệ sung huyết tĩnh mạch tại vạt là 9,4% và tự hồi phục không cần can thiệp. Tỷ lệ sống còn của vạt là 100%. Kết quả phục hồi chức năng sau phẫu thuật tốt là 93,8% và kết quả thẩm mỹ từ trung bình trở lên là 94,1% – 100%. Kết luận: Vạt đảo mũi má là lựa chọn phù hợp, đáng tin cậy trong tái tạo khuyết hổng vùng mặt với nhiều ưu điểm như phẫu thuật một thì, màu sắc – cấu trúc mô phù hợp, linh hoạt, bảo tồn chức năng cơ quan và thẩm mỹ tốt.To assess the effectiveness of island pedicle nasolabial flap in reconstruction after radical resection of facial skin cancer Methods: A prospective descriptive study on 32 patients with facial skin cancer undergoing radical resection with subsequent facial reconstruction using island pedicle nasolabial flaps in Ho Chi Minh City Oncology hospital between January 2021 and October 2022.ss Results: 32 island pedicle nasolabial flaps were employed for reconstruction following radical resection of facial skin cancer. The maleto- female ratio approximated 1.46. The mean patient age was 65.7 years (range, 46-92 years). Histopathological results revealed a predominance of basal cell carcinoma (71.9%), followed by squamous cell carcinoma (28.1%). Stage 2 and 3 tumorse were most prevalent (65.7%), while T4 constituting 12.5%. Complex defects constituted the preponderant pathology, comprising 59.4% of cases. The maximum flap dimension was 6.5cm x 8cm (mean size: 3.5cm x 6cm). Follow-up periods extended from 3 to 22 months (median time: 6 months). One case (3.1%) of local tumor recurrence was reported. Flap venous congestion occurred in only three patients (9.4%) and was resolved spontaneously without intervention. All flaps demonstrated complete survival (100%). Good postoperative functional recovery was observed in 93.8% of patients, and average and above-average aesthetic outcomes were achieved in 94.1% - 100% patients. Conclusions: Island pedicle nasolabial flap is a suitable and reliable option for facial reconstruction with many advantages, including one-stage surgery, well-matched tissue color and texture, flexibility, postoperative functional preservation, and optimal aesthetic outcome.

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