Clinical experience with 80 microvascular couplers in 64 free osteomyocutaneous flap transfers for mandibular reconstruction
Clinical experience with 80 microvascular couplers in 64 free osteomyocutaneous flap transfers for mandibular reconstruction
复制标题
80个微血管耦合器64例游离骨肌皮瓣移植下颌骨重建的临床经验
DOI：
10.1016/j.ijom.2015.07.011
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发表时间：
2015-10-01
影响因子：
2.4
通讯作者：
Shane, Z. -J.
中科院分区：
文献类型：
--
作者：
Wang, L.;Liu, K.;Shane, Z. -J.
微血管耦合器已被引入作为下颌骨重建的替代吻合方法。本研究纳入了64例接受下颌骨缺损游离皮瓣重建的患者，并计划在1、3、6和12个月进行随访。在完成肿瘤切除和骨肌皮瓣的收获后，对血管的两端进行适当的准备以进行显微手术。单静脉栓塞35例，双静脉栓塞29例。除75个耦合器仅用于静脉吻合外，7个皮瓣均使用耦合器进行动、静脉吻合。在这些病例中没有皮瓣失败，导致皮瓣的整体成功率为100%。正如预期，80例尝试病例中有78例（97.5%）使用耦合器成功完成了手术。还需要更多的大型随机研究来比较耦合器固定与传统缝合固定的结果，并确定这在多大程度上可以节省每例手术的成本。
Microvascular couplers have been introduced as an alternative method for anastomosis in mandibular reconstruction. This study included 64 patients who had undergone free flap reconstruction for mandibular defects and had been scheduled for follow-up at 1, 3, 6, and 12 months. After completion of the tumour resection and harvesting of the osteomyocutaneous flap, appropriate preparation of both ends of the vessels was performed for microsurgery. Single-vein anastomoses were performed in 35 patients and double-vein anastomoses in 29 patients. Except for 75 couplers used for venous anastomosis only, both arterial and venous anastomoses were performed using the coupler in seven flaps. No flap failures occurred in these cases, resulting in an overall flap success rate of 100%. As expected, anastomoses were completed successfully using the coupler in 78 out of 80 attempted cases (97.5%). Additional large and randomized studies are needed to compare the outcomes of coupler anastomoses to those of traditional sutured anastomoses, and to define to what extent this would present cost-savings per procedure.