1/4. Versatility of the free anterolateral thigh flap for reconstruction of soft-tissue defects: review of 140 cases.From August 1995 to June 1999, 140 free anterolateral thigh (ALT) flaps were transferred to reconstruct a variety of soft-tissue defects. The size of ALT flap ranged from 10 to 33 cm in length and 4 to 14 cm in width. Based on the anatomic variations of the perforators, the blood supply to the skin island came from the septocutaneous perforators only in 19 patients (13.6%), arising from the descending or transverse branch of the lateral circumflex femoral artery (LCFA), or originating directly from LCFA. The other flaps were supplied by musculocutaneous perforators that were elevated as a true perforator flap via intramuscular dissection (N = 34, 24.3%), or used a cuff of vastus lateralis muscle for added bulk (N = 87, 62.1%). The overall success rate was 92% (129 of 140). After a 2-year follow-up, all flaps have healed unevenffully and donor thigh morbidity is minimal. Anatomic variations must be considered if the ALT flap is to be used safely and reliably.- - - - - - - - - - ranking = 1keywords = dissection (Clic here for more details about this article) |
2/4. head and neck cancer with simultaneous lung cancer.The simultaneous occurrence of a primary malignant tumor of the lung or pulmonary metastasis in patients with head and neck cancer is uncommon. In response to the question, "Are efforts toward management of cancer in the head and neck region in a person with simultaneous malignant tumor of the lung an exercise in futility?" we present six cases evaluated at the louisiana State University health Sciences Center in Shreveport during a 19-year period. men with squamous cell cancers at both locations and locally advanced malignant tumors of the lung were predominant in this series of patients. Chemoradiation was applied because of extensive disease at one or both neoplastic sites. Long-term survival was not observed in most patients (including the aggressively treated individuals) whose malignant neoplasms were concurrently managed by non-operative means.- - - - - - - - - - ranking = 5.2663239367107keywords = neck (Clic here for more details about this article) |
3/4. Seeding of malignant renal tumor through a nephrostomy tract.We present 2 patients who suffered from obstructive uropathy and received percutaneous nephrostomy diversion. After a series of studies, the diagnoses were transitional cell carcinoma and squamous cell carcinoma, respectively. Unfortunately, tumor seeding through a percutaneous nephrostomy tract developed after radical operation. Wide excision of recurrent tumors was performed and no local recurrence could be found after a follow-up more than 1 year later. Malignancy seeding through the percutaneous nephrostomy tract should always be kept in mind when we deal with patients of obstructive uropathy caused by suspected malignancy.- - - - - - - - - - ranking = 0.28960823212529keywords = radical (Clic here for more details about this article) |
4/4. Severe postextubation laryngeal obstruction: the role of prior neck dissection and radiation.Aggressive treatment of advanced head and neck cancer may result in more patients undergoing surgery for unrelated illnesses. We present a case of a patient requiring emergency tracheostomy placement after a routine liver segment resection 10 yr after undergoing a bilateral modified radical neck dissection and radiation therapy. This type of patient may be at increased risk for both postoperative laryngeal edema and neuronal imbalance secondary to their preoperative condition.- - - - - - - - - - ranking = 10.555932168836keywords = dissection, neck, radical (Clic here for more details about this article) |