{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390001205222720512.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.5981/jjhnc.41.411"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/jjhnc/41/4/41_411/_pdf"}},{"identifier":{"@type":"NAID","@value":"130005119902"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2016204224"}}],"dc:title":[{"@language":"ja","@value":"外側胸動脈系血行付与による大胸筋皮弁変法術式による口腔癌切除後再建の有用性に関する臨床的検討"},{"@language":"en","@value":"Clinical study on feasibility of a modified pectoralis major myocutaneous flap technique with additional vascular supply and an extended rotation arc for reconstruction of surgically induced defects in oral cancer patients"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"The pedicled pectoralis major myocutaneous (PMMC) flap is versatile and still used for the reconstruction of surgical defects following oral, head and neck cancer resection. Although microvascularized free-tissue transfer is often used as the main flap method for oral and maxillofacial reconstruction, it cannot be used effectively in certain situations, such as in recurrence after reconstruction (salvage), poor systemic or local conditions, in arteriosclerosis, and/or in the very elderly. According to individual considerations for oral cancer treatment, the clinical benefits of the PMMC flap should not be overlooked. When harvesting the PMMC flap, we modified the conventional technique: (1)Use of the subclavian route and (2) Preservation of the lateral thoracic vessels. These modified PMMC flap preparation techniques ensure sufficient blood supply and an increased rotation arc. We have applied this modified technique instead of microvascularized free flaps or conventional PMMC flap techniques since 2013. To date, we have treated 8 patients with advanced or recurrent (salvage) oral cancer, as well as very elderly patients, with our modified technique and no critical flap problems or fistula formation have occurred. In this retrospective clinical study, we review this modified PMMC flap and compare the clinical results for the treatment of surgical defects following oral cancer resection in terms of the feasibility of additional blood supply of the lateral thoracic vessels in the clinical setting."},{"@language":"ja","@value":"口腔癌切除後の欠損部再建には，近年血管柄付き遊離皮弁再建術が広く用いられる。しかし，再発癌の救済手術時や，局所や全身的な問題，また高齢患者においては，遊離皮弁再建術が適さない場合もある。大胸筋皮弁はその低侵襲性から，とくに個別化治療の観点から，遊離皮弁が主流である現在でも依然として臨床的有用性は高い。しかし，本皮弁原法術式の欠点は，到達距離の制限と，まれではあるが血行不安定性による部分壊死の発症である。そこでわれわれは2013年より，(1) 鎖骨下を通すルートへの改変に加え，(2) 胸肩峰動脈胸筋枝に外側胸動脈血行系を温存付与する術式の変更を行った。これまでに，進行症例，救済手術症例および高齢患者の8症例にこの変法術式を適応し，良好な臨床成績を得ている。そこで今回，その変法術式において，外側胸動脈血行系を付与する有用性に関して，付与しなかった症例と臨床的後方視的に比較評価検討を行った。"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1420001326234179072","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"60633360"},{"@type":"NRID","@value":"1000060633360"},{"@type":"NRID","@value":"9000411805632"},{"@type":"NRID","@value":"9000409026973"},{"@type":"NRID","@value":"9000402483153"},{"@type":"NRID","@value":"9000014419291"},{"@type":"NRID","@value":"9000004579304"},{"@type":"NRID","@value":"9000351087170"},{"@type":"NRID","@value":"9000313615678"},{"@type":"NRID","@value":"9000399852135"},{"@type":"NRID","@value":"9000258078945"},{"@type":"NRID","@value":"9000415155232"},{"@type":"NRID","@value":"9000394464964"},{"@type":"NRID","@value":"9000399010542"},{"@type":"NRID","@value":"9000391517702"},{"@type":"NRID","@value":"9000411072111"},{"@type":"NRID","@value":"9000392057738"},{"@type":"NRID","@value":"9000241766100"},{"@type":"NRID","@value":"9000367422179"},{"@type":"NRID","@value":"9000345247581"},{"@type":"NRID","@value":"9000356633947"},{"@type":"NRID","@value":"9000399010551"},{"@type":"NRID","@value":"9000399010512"},{"@type":"NRID","@value":"9000345218369"},{"@type":"NRID","@value":"9000345247625"},{"@type":"NRID","@value":"9000391517692"},{"@type":"NRID","@value":"9000391517896"},{"@type":"NRID","@value":"9000360565132"},{"@type":"NRID","@value":"9000398261038"},{"@type":"NRID","@value":"9000408628389"},{"@type":"NRID","@value":"9000313615675"},{"@type":"NRID","@value":"9000404826605"},{"@type":"NRID","@value":"9000392057677"},{"@type":"NRID","@value":"9000409631863"},{"@type":"NRID","@value":"9000415171945"},{"@type":"NRID","@value":"9000370745335"},{"@type":"NRID","@value":"9000345247612"},{"@type":"NRID","@value":"9000392056873"},{"@type":"NRID","@value":"9000399361980"},{"@type":"NRID","@value":"9000388449158"},{"@type":"NRID","@value":"9000399010564"},{"@type":"NRID","@value":"9000391517870"},{"@type":"NRID","@value":"9000287291927"},{"@type":"NRID","@value":"9000258209649"},{"@type":"NRID","@value":"9000392057973"},{"@type":"NRID","@value":"9000399851799"},{"@type":"NRID","@value":"9000356633932"},{"@type":"NRID","@value":"9000404144820"},{"@type":"NRID","@value":"9000408628378"},{"@type":"NRID","@value":"9000327097524"},{"@type":"NRID","@value":"9000316691851"},{"@type":"NRID","@value":"9000409631850"},{"@type":"NRID","@value":"9000409631871"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/t-kanno"}],"foaf:name":[{"@language":"ja","@value":"管野 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Yoshiki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Oral and Maxillofacial Surgery, Matsue City 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flap"},{"@id":"https://cir.nii.ac.jp/all?q=Oral%20cancer","dc:title":"Oral cancer"},{"@id":"https://cir.nii.ac.jp/all?q=Reconstruction","dc:title":"Reconstruction"},{"@id":"https://cir.nii.ac.jp/all?q=Blood%20supply","dc:title":"Blood supply"},{"@id":"https://cir.nii.ac.jp/all?q=Clinical%20feasibility","dc:title":"Clinical feasibility"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360004234912135296","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Supercharged Pectoralis Major Musculocutaneous Flap"}]},{"@id":"https://cir.nii.ac.jp/crid/1360846640278309376","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Analysis of risk factors for surgical-site infections in 276 oral cancer surgeries with microvascular free-flap reconstructions at a single university 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