두경부 재건수술 초기경험: 적절성과 임상결과 연구

Abstract

Background and Objectives The reconstruction of surgical defects in head and neck cancer patients requires thorough anatomical knowledge and considerable clinical experiences, hence it is a demanding job for un-experienced reconstructive surgeons. We evaluated the appropriateness and the surgical outcome of a one-year experience of head and neck reconstruction carried out in a tertiary hospital setting. Subjects and Method We performed a retrospective review of the medical records of 73 patients who underwent reconstructive surgery at the Otolaryngology Department and Plastic Surgery from January, 2012 to September, 2016. Results Twenty-eight of 42 patients underwent free-flap reconstruction, including anterolateral thigh, radial forearm, or fibula free-flap by a head and neck surgeon. The rest of the patients underwent pedicled-flap surgery including pectoralis major or latissimus dorsi myocutanous flap. The mean operation time was 209.5 minutes and an average of 1.2 days intensive care unit- and 37.2 days of hospital stay were required in the free-flap cases. The flap failure happened in three patients, two in free-flap and one in pedicled flap. These surgical outcomes were comparable to those of the plastic surgery patient group. Conclusion The technical appropriacy and acceptable outcome of head and neck reconstruction by head and neck surgeons was proven in this investigation. We propose that reconstructive surgery should be performed by head and neck surgeons as they could reduce operation time or complications because of their familiarity with complex surgical anatomy and early decision making competency. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(4):179-82