European Archives of Oto-Rhino-Laryngology ( IF 1.9 ) Pub Date : 2023-10-19 , DOI: 10.1007/s00405-023-08287-0 Alessandro Rosti 1, 2 , Alessandro Ammar 3 , Marco Pignatti 2, 3 , Gabriele Molteni 1, 2 , Alberto Franchi 4 , Riccardo Cipriani 3 , Livio Presutti 1, 2 , Matteo Fermi 1, 2
Background
In the surgical treatment of head and neck locally advanced malignancies, microvascular free flaps represent the most valuable solution to reconstruct the tissue defect after resection of the primary neoplasm. In particular, microvascular free flaps allow to restore the functional and aesthetical features of the head and neck compartments. The superficial circumflex iliac perforator (SCIP) flap represents, as an evolution of the groin flap, a valid alternative to the radial fasciocutaneous free (RFFF) flap or the anterolateral thigh (ALT) flap.
Methods
This systematic review adhered to the recommendations of the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) 2009 guidelines. A computerized MEDLINE search was performed using the PubMed service of the U.S. National Library of Medicine (www.pubmed.org) and Scopus database (www.scopus.com). Two authors screened the articles, then selected and extracted data on malignancies characteristics, reconstructive techniques, outcomes, and complications.
Results
A total of 25 articles were selected and reviewed among the 39 identified through the search string. Six out of the selected 25 articles were case reports, while the remaining 19 articles were retrospective case series. The whole study population was represented by 174 oncologic patients undergoing ablation of a head and neck tumor and reconstruction with a SCIP flap. The site of reconstruction was the oral cavity in 125 (71.0%) patients, being the tongue the most common subsite in 73 (41.5%) patients, the pharynx in 10 (5.7%) cases, the larynx in 3 (1.7%) and head and neck skin in 36 (20.4%) patients. Only two cases of total flap loss were reported. Partial flap loss or shrinkage requiring minor surgical revisions was observed in 11 patients (6.32%). Primary closure of the donor site was achieved in the whole study population, according to the available data.
Conclusions
In head and neck postoncological reconstruction, despite the caliber and the length of the pedicle, SCIP flap offers a pliable and thin skin paddle, allowing single-stage resurfacing, medium to large skin paddle, possibility of composite-fashion harvest and a well-concealed donor site.
中文翻译:
SCIP 皮瓣在肿瘤消融手术后头颈部重建中的应用:系统评价
背景
在头颈部局部晚期恶性肿瘤的外科治疗中,微血管游离皮瓣代表了原发肿瘤切除后重建组织缺损的最有价值的解决方案。特别是,微血管游离皮瓣可以恢复头颈区的功能和美学特征。作为腹股沟皮瓣的演变,旋髂浅穿支 (SCIP) 皮瓣是径向游离筋膜皮瓣 (RFFF) 或大腿前外侧 (ALT) 皮瓣的有效替代方案。
方法
本系统评价遵循系统评价和荟萃分析 (PRISMA) 2009 年指南的首选报告项目的建议。使用美国国家医学图书馆 (www.pubmed.org) 的 PubMed 服务和 Scopus 数据库 (www.scopus.com) 进行计算机化 MEDLINE 检索。两位作者筛选了这些文章,然后选择并提取了有关恶性肿瘤特征、重建技术、结果和并发症的数据。
结果
通过搜索字符串确定的 39 篇文章中,总共选择并审查了 25 篇文章。入选的 25 篇文章中有 6 篇是病例报告,其余 19 篇文章是回顾性病例系列。整个研究人群由 174 名接受头颈部肿瘤消融和 SCIP 皮瓣重建的肿瘤患者代表。 125 例 (71.0%) 患者的重建部位为口腔,73 例 (41.5%) 患者中最常见的是舌头,咽部 10 例 (5.7%),喉 3 例 (1.7%), 36 名 (20.4%) 患者的头颈部皮肤。仅报告了两例皮瓣完全丢失的病例。 11 名患者 (6.32%) 观察到部分皮瓣丢失或收缩,需要进行较小的手术修复。根据现有数据,整个研究人群实现了供体部位的初步闭合。
结论
在头颈部肿瘤后重建中,尽管蒂的口径和长度不同,但 SCIP 皮瓣提供了柔韧且薄的皮板,允许单阶段表面重修、中型至大型皮板、复合时尚收获的可能性和良好的隐蔽性捐助网站。