Plastic and Reconstructive Surgery

Introduction

The Division of Plastic and Reconstructive urgery has mainly focused on surgical reconstruction after cancer ablation. In our institution, reconstructive procedures using free flap transfer with microvascular anastomosis are the most important surgeries. In addition, several methods, such as tissue transfer with pedicled flap, local flap transfer, skin grafting, etc., are used for reconstructive surgery. The objective of reconstructive surgery is not only morphological reconstruction but also restoration of function after ablative surgery, thereby improving the quality of life (QOL) of the patient.

Routine Activities

Three plastic surgeons perform the reconstructive surgeries in both the NCCH East in Kashiwa and the NCCH in Tokyo and train the residents in these 2 hospitals. Every week, 3–4 reconstructive surgeries are performed in collaboration with the surgeons of other divisions of the hospital, such as the Head and Neck Surgery, Orthopedic Surgery, Esophageal Surgery, Breast Surgery, Colorectal Surgery, and Urological Surgery Divisions. Among these, the most frequently performed reconstructive surgeries are for head and neck cancers, accounting for 68% of all reconstructive surgeries. In reconstructive procedures of the head and neck region, jejunal free flaps and rectus abdominis musculocutaneous flaps are used most frequently.

● M. Sakuraba ●

Cooperation with other divisions
  NCCH East NCCH Tokyo Total
Head & Neck surgery 132 53 185
Orthopedic surgery ---- 38 38
Esophageal surgery 5 10 15
Breast surgery 6 3 9
Dermatology ---- 10 10
Urological surgery 8 0 8
HB & P surgery 0 3 3
Ophthalmic surgery ---- 6 6
Colorectal surgery 6 3 9
Thoracic surgery 1 2 3
Gynecology ---- 2 2
Total 158 128 286
HB&P: Hepatobiliary and pancreatic

Operative procedures
  NCCH East NCCH Tokyo Total
Microvascular free flaps 113 49 162
Jejunal 36 17 53
RAMC 51 10 61
Anterolateral thigh 13 12 25
Fibular 8 4 12
Latissimus Dorsi 1 3 4
Radial Forearm 0 2 2
Other flaps 4 1 5
Other Microsurgeries 13 12 21
Supercharge Method 4 1 5
Nerve Grafting 9 0 9
Limb Salvage 0 2 2
Hepatic Artery Repair 0 3 3
Others 0 3 3
Subtotal 126 57 183
Pedicled flaps 22 51 73
PMMC 7 13 20
Latissimus Dorsi 1 5 6
RAMC 0 4 4
Other flap 14 29 43
Other procedures 12 22 34
Total 160 130 290
RAMC: Rectus abdominis musculocutaneous flap

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