Comparing Functional Outcomes Following TORS With Free Flap Reconstruction Using a Radial Forearm vs. Anterolateral Thigh Flap.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-09-12 DOI:10.1002/hed.70039

Praneet Kaki, Doreen Lam, Neel R Sangal, Ryan M Carey, Karthik Rajasekaran, Ara Chalian, Robert M Brody, Gregory S Weinstein, Steven B Cannady

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引用次数: 0

Abstract

Background: Free flap reconstruction (FFR) following transoral robotic surgery (TORS) is commonly performed using radial forearm free flaps (RFFF). This study compares patterns of functional recovery between RFFFs and anterolateral thigh flaps (ALTFs).

Methods: Retrospective cohort study of patients with oropharyngeal cancer who underwent TORS with FFR (2010-2023) at a tertiary care center. A 1:4 ALTF:RFFF propensity score match was performed. Functional Oral Intake Scale (FOIS) assessed outcomes.

Results: The 105 patients were included. ALTF patients had lower FOIS at 6 months (3[2.0, 5.0] vs. 5.0[2.0, 6.0], p = 0.045) and 1 year (5.0[2.0, 6.0] vs. 6.0[5.0, 6.8], p = 0.045), with higher PEG tube rates. ALTFs were used for larger defects (62.95 ± 20.25 cm² vs. 51.17 ± 15.11 cm², p = 0.014). Donor site morbidity or postoperative complications were similar between cohorts.

Conclusions: ALTFs are suitable for larger defects and lead to slower early functional recovery with higher PEG tube rates compared to RFFFs, with no difference in complications.

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前臂桡骨与大腿前外侧游离皮瓣重建TORS后功能结果的比较。

背景：经口机器人手术（TORS）后的自由皮瓣重建（FFR）通常使用桡骨前臂自由皮瓣（RFFF）进行。本研究比较了RFFFs和大腿前外侧皮瓣（ALTFs）之间的功能恢复模式。方法：回顾性队列研究2010-2023年在某三级保健中心接受tor伴FFR的口咽癌患者。进行1:4 ALTF:RFFF倾向评分匹配。功能性口服摄入量表（FOIS）评估结果。结果：纳入105例患者。ALTF患者在6个月（3[2.0,5.0]vs. 5.0[2.0, 6.0], p = 0.045）和1年时（5.0[2.0,6.0]vs. 6.0[5.0, 6.8], p = 0.045） FOIS较低，PEG管率较高。ALTFs用于较大的缺陷（62.95±20.25 cm2 vs. 51.17±15.11 cm2, p = 0.014）。供体部位发病率或术后并发症在队列之间相似。结论：与RFFFs相比，ALTFs适用于较大的缺损，早期功能恢复较慢，PEG管率较高，并发症无差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.