Preview

Head and Neck Tumors (HNT)

Advanced search

Microsurgical head and neck tissue repair by visceral mini-autografting

https://doi.org/10.17650/2222-1468-2015-5-2-14-19

Abstract

Objective. To minimize surgical trauma in patients with head and neck tumors during microsurgical plasty with visceral autografts.

Subjects and methods. Clinical experience has been gained in the treatment of 53 patients with locally advanced craniofascial (n = 27) and oropharyngeal (n = 36) cancers. Abdominal organs were used for plastic closure of extensive defects after surgical resection. Paraumbilical incision allowing for an adequate approach into the abdominal cavity with minimal external trauma in the anterior abdominal wall was chosen as an access procedure. Video-assisted techniques were used to excise the midline aponeurosis. Donor organs, such as the omentum, greater curvature of the stomach, transverse colon, small intestine) were taken through a mini-laparotomic incision to the anterior abdominal wall, then the vascular pedicle was exposed and a visceral autograft was made. After forming and cutting off the autograft, organ anastomoses were created extracorporeally.

Results. Mini-access surgery could be completed in 50 of the 53 cases (4 patients had previously undergone abdominal interventions). Omental (n = 26), colo-omental (n = 15), gastro-omental (n = 7), and entero-omental (n = 5) flaps were made and prepared for autografting. No intra- or postoperative abdominal complications were found.

Conclusion. Minimally invasive technologies used to create visceral authografts for head and neck tissue repair can minimize surgical trauma and reduce treatment duration. The indications for this access are the debilitating state of a cancer patient or the young age of a patient who does not wish to have an additional scar in the donor region.

About the Authors

A. D. Kaprin
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


I. V. Reshetov
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Bldg. 2, 8 Trubetskaya St., Moscow, 119991, Russia


M. V. Ratushnyi
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


S. A. Kravtsov
Oncology Clinical Dispensary One, Moscow Healthcare Department
Russian Federation
17/1 Baumanskaya St., Moscow, 105005, Russia


A. P. Polyakov
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


O. V. Matorin
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


F. E. Sevryukov
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


M. M. Filyushin
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


V. N. Vasilyev
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


I. V. Rebrikova
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, Branch, P.A. Herzen Federal Medical Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinsky Proezd, Moscow, 125284, Russia


References

1. Старинский В.В., Александрова Л.М., Чиссов В.И. и др. Основные итоги четырехлетнего опыта реализации мероприятий, направленных на совершенствование онкологической помощи населению России. Онкология 2014;4;45–9. [Starinskiy V.V., Alexandrova L.M., Chissov V.I. et al. Main results of the four-year experience of implementation of events aimed at improvement of oncology aid to the population of Russia. Onkologiya = Oncology 2014;4;45–9. (In Russ.)].

2. Иванов В.М., Матякин Е.Г. Реконструктивно-пластические операции у пациентов пожилого и старческого возраста со злокачественными опухолями орофарингеальной области. Анналы пластической, реконструктивной и эстетической хирургии 2006;2;79–80. [Ivanov V.M., Matyakin E.G. Reconstruction and plastic surgery of the elderly and old patients with malignant tumors in the oropharyngeal area. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii = Annals of Plastic, Reconstruction, and Aesthetic Surgery 2006;2;79–80. (In Russ.)].

3. Шинкарев С.А. Пластика при операциях по поводу опухолей головы и шеи. Материалы Всероссийской научно-практической конференции «Опухоли головы и шеи». Сибирский онкологический журнал 2006;прил. 1;143. [Shinkaryev S.A. Plastics in the course of surgeries for head and neck tumors. materials of the all-russian research and practical conference “Head and Neck Tumors”. Sibirskiy onkologicheskiy zhurnal = Siberian Oncological Journal 2006;(supрl 1); 143. (In Russ.)].

4. Чиссов В.И. Принципиальный подход к функционально-щадящему лечению больных со злокачественными опухолями. М., 1991. С. 5–9. [Chissov V.I. Principal аpproach to functional and sparing treatment of patients with malignant tumors. Moscow, 1991. Pp. 5–9. (In Russ.)].

5. Решетов И.В., Чиссов В.И. Пластическая и реконструктивная микрохирургия в онкологии. М., 2001. С. 5. [Reshetov I.V., Chissov V.I. Plastic and reconstruction microsurgery in oncology. Мoscow, 2001. P. 5. (In Russ.)].


Review

For citations:


Kaprin A.D., Reshetov I.V., Ratushnyi M.V., Kravtsov S.A., Polyakov A.P., Matorin O.V., Sevryukov F.E., Filyushin M.M., Vasilyev V.N., Rebrikova I.V. Microsurgical head and neck tissue repair by visceral mini-autografting. Head and Neck Tumors (HNT). 2015;5(2):14-19. (In Russ.) https://doi.org/10.17650/2222-1468-2015-5-2-14-19

Views: 1273


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2222-1468 (Print)
ISSN 2411-4634 (Online)