NicolásFlores Moltedo一位來自智利的顯微外科醫師

Nicolás Flores Moltedo

前大腿外側皮瓣(anterolateral thigh flap, ALT)是整形外科進行頭頸癌重建最標準也是最常用的皮瓣。然而有時後會因為病患兩側大腿的前大腿外側皮瓣已經被使用過或無法使用,或者因為皮瓣的血管穿透枝(perforator)口徑不足、不存在或於摘取過程中受損,而必須使用另一種皮瓣才能進行重建。
在這種情況下,大腿前內側皮瓣(anteromedial thigh flap, AMT)便是一種相當有用之選項。但是對於AMT之成功率和ALT是否有所異同值得作進一步之探討。我們分析了於2008年3月1日至2017年2月28日期間,用於進行頭頸癌重建的1,547個ALT和57個AMT,發現和ALT相比,AMT比較常用於復發的癌症患者(可能因為ALT可能被用過了),但較少用於位於深部的癌症(可能因為AMT的血管較短、摘取技術較困難、或對於更困難的案例傾向使用較為熟悉的ALT)。我們選擇了40對傾向得分匹配的患者(propensity score-matched patient populations)來進行後續分析,以減少因患者和手術特徵的差異影響結果之評估後,發現AMT的失敗率還是明顯高於ALT(15.0 vs. 0.0%, p = .026)。此篇論文已經由Microsurgery刊出。
這篇論文是由謝青華醫師指導來本院學習的顯微手術fellow智利醫師Nicolás Flores Moltedo所撰寫。他現在回到其國家於Public Assistance Emergency Hospital燒傷中心服務,並從事顯微等重建手術。論文發表後,他特別寫了一段感想如下: 

During my one-year clinical fellow in microsurgery. I had the opportunity to see many cases of microsurgical reconstruction. That’s when I started thinking on different topics to research and write. Being the free anterolateral thigh flap the most use, I decided to make a comparison between the ALT and AMT. During the writing it was very useful because it encourages me to read and research about that topic. That gave me knowledge and learn more about plastic surgery reconstruction. Another point starting the fellow one of my goals was to publish an article. And finally we did with a team work with plastic surgery service. Thank you.

  • Nicolás Flores Moltedo
Nicolás Flores Moltedo

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