Comparison of morbidity after reconstruction of tongue defects with an anterolateral thigh cutaneous flap compared with a radial forearm free-flap: a meta-analysis
Comparison of morbidity after reconstruction of tongue defects with an anterolateral thigh cutaneous flap compared with a radial forearm free-flap: a meta-analysis
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DOI：
10.1016/j.bjoms.2016.07.026
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发表时间：
2016-12-01
影响因子：
1.8
通讯作者：
Song, S.
中科院分区：
文献类型：
--
作者：
Chen, H.;Zhou, N.;Song, S.
前臂桡侧筋膜皮瓣和股前外侧皮瓣是目前应用最广泛的游离皮瓣。然而，由于它们各自的内在特性，它们在舌缺损重建后的有效性存在争议，因此我们使用荟萃分析比较了它们在舌缺损重建中的作用。我们在Pubmed、EMBASE、奥维德、Science Direct、科克伦图书馆和中国国家知识基础设施中进行了检索，涵盖了2015年1月之前发表的所有论文。12篇临床文献，包括366例患者的198个前臂桡侧皮瓣和168个前外侧皮瓣，符合标准。使用系统性荟萃分析提取并分析了相关数据。结果表明，前臂桡侧皮瓣供区术后局部麻木的发生率明显高于股前外侧组，而对供区外观的满意度明显低于股前外侧组。在皮瓣存活率、皮瓣血管危象发生率、并发症、对舌外观的满意度或术后语言清晰度和吞咽能力方面没有差异。结果表明，股前外侧皮瓣是修复舌缺损的理想软组织瓣，供区麻木感最小，患者满意度更高。需要进一步的研究来解决手术缺损的部位和程度的细节，以及桡侧皮瓣的解剖和植皮修复之间的关系。(C)2016年英国口腔颌面外科医师协会。由爱思唯尔有限公司出版。保留所有权利。
Currently the radial forearm fasciocutaneous flap and the anterolateral thigh flap are among the most popular free flaps used for reconstruction of oral soft tissue. However, there is controversy about their efficacy after reconstruction of tongue defects because of their respective intrinsic properties, so we have compared them in reconstruction of tongue defects using meta-analysis. We conducted a search in Pubmed, EMBASE, OVID, Science Direct, the Cochrane Library, and Chinese National Knowledge Infrastructure, which covered all papers published before January 2015. Twelve clinical papers, that included 366 patients with 198 radial forearm flaps and 168 anterolateral flaps, met the criteria. Relevant data were extracted and analysed using systematic meta-analyses. The results showed that the incidence of localised numbness at the donor site of the radial forearm flap postoperatively was significantly higher and satisfaction with the appearance of the donor site significantly lower than in the anterolateral thigh group. There were no differences in flap survival, incidence of vascular crises in the flap, complications, satisfaction with the appearance of the tongue, or the postoperative clarity of speech and swallowing ability. Results suggested that the anterolateral thigh flap is the ideal soft tissue flap for reconstructing defects in the tongue, as there was minimal numbness at the donor site and patients were much more satisfied. Further research is needed to address details of the site and the extent of surgical defects as well as the relations between dissection of the radial flap and repair of the skin graft. (C) 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.