O RETALHO MUSCULO-CUTANEO DO PEITORAL MAIOR NA RECONSTRUÇAO DO CANCER DE CABEÇA E PESCOÇO





O RETALHO MUSCULO-CUTANEO DO PEITORAL MAIOR NA RECONSTRUÇAO DO CANCER DE CABEÇA E PESCOÇO

(especial para SIIC © Derechos reservados)
O retalho foi adequado funcionalmente tanto na reconstrução da neofaringe quanto no reparo de grandes perdas de substância. Assim, trata-se de um método versátil, com bom resultado funcional.
dedivitis.jpg Autor:
Rogério A. Dedivitis
Columnista Experto de SIIC
Artículos publicados por Rogério A. Dedivitis
Coautor
André V. Guimarães* 
MD, Hospital Heliópolis Hosphel, São Paulo, Brasil*
Recepción del artículo
1 de Agosto, 2003
Primera edición
15 de Marzo, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Descrito inicialmente por Ariyan na década de 1970, o retalho do músculo peitoral maior teve grande aceitação pela sua versatilidade nas reconstruções de cabeça e pescoço. É irrigado pela artéria tóraco-acromial com uma circulação adicional proporcionada pela artéria torácica lateral. Pode ser utilizado com segurança em pacientes submetidos a tratamento radioterápico adjuvante. O objetivo deste trabalho é analisar retrospectivamente indicações e resultados desta técnica reconstrutiva em 17 pacientes com câncer de cabeça e pescoço. Indicamos esse retalho para a reconstrução do soalho da boca e língua (7 pacientes); trânsito faringo-esofágico após faringo-laringectomia (7 pacientes); partes moles de face após ressecção de câncer de parótida (1); e partes moles de região cervical após ressecção de pele durante esvaziamento cervical (2). Necrose total do retalho por reconstrução faringo-esofágica foi observada em um paciente e necrose parcial no soalho da boca após reconstrução do mesmo. Perda parcial do retalho de pele com deiscência parcial ocorreu em quatro casos em pacientes submetidos a reparo de língua e soalho de boca, porém, sem fístula e infecção. Houve formação seroma no sítio doador em um paciente. O retalho foi adequado funcionalmente tanto na reconstrução da neofaringe quanto no reparo de grandes perdas de substância. Assim, trata-se de um método versátil, com bom resultado funcional.


Artículo completo

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Abstract
Described initially by Ariyan in the 1970s decade, the pectoralis major flap has great acceptance for its versatility for the head and neck cancer reconstructions. It is supplied by the thoracoacromial artery with an additional circulation provided by the lateral thoracic artery. It can be safely used even in the patients underwent postoperative radiation. The objective of this work is to analyze retrospectively the indications and results of this reconstruction technique in 17 patients with head and neck cancer. We have indicated the flap for the reconstruction of floor of the mouth and tongue (7 patients); pharyngoesophageal transit after pharyngolaryngectomy (7 patients); face soft part after parotid cancer excision (1); and soft part of cervical area after skin excision during cervical dissection (2). Total necrosis of the flap for pharyngoesophageal reconstruction was observed in one patient and partial necrosis in the floor of the mouth reconstruction. Partial loss of the flap skin with partial deiscence occurred in four cases in patients underwent tongue and floor of the mouth repair but without fistulae and infection. There was donor site seroma in one patient. The flap was functionally adequate both in the reconstruction of the neopharynx and for repair of great surgical defects. So it is a versatile method with good functional result.


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Otorrinolaringología
Relacionadas: Cirugía, Oncología



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Bibliografía del artículo
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Especialidad principal:
Otorrinolaringología


Relacionadas:
Cirugía
Oncología
 
 
 
 
 
 
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