Plastic and Reconstructive Surgery Division
Introduction
In order to improve the quality of life of patients, Plastic and Reconstructive Surgery has focused on the following 3 aspects in the surgical treatment of cancer:
1. Obtaining good functional recovery;
2. Reducing postoperative complications;
3. Decreasing donor site morbidity
With the objective of resolving these issues, establishing certain standard procedures for reconstructive surgery and developing new techniques for reconstructive procedures were the most important aims of our studies.
Standardization of Reconstructive Surgery
In the field of head and neck surgery, 25% of the patients who undergo surgical treatment require reconstructive surgery. However, there is no standard procedure for reconstructive procedures. An algorithm for reconstructive surgery for the defects after total or subtotal maxillectomy was established for our institute (63).
Multiinstitutional analysis of postoperative quality of life after tongue resection and reconstruction is currently in progress. This study is being supported by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour, and Welfare of Japan, and the aim of this study is to clarify the relationship between the clinical indicators and the postoperative quality of life.
Development of a New Technique for Reconstructive Procedures
Several new techniques for reconstructive surgery were developed, or the conventional surgical procedures were modified.
Restoration of erectile function by nervegrafting after total prostatectomy and bilateral cavernous nerve resection are being performed since 2005 in cooperation with the Division of Urology. Twenty-one consecutive patients were followed up with analysis of erectile function. Erectile function was restored in 5 patients (23.8%); however, sexual intercourse was not possible in any of the patients. Currently, additional methods are being introduced for achieving satisfactory erectile function postoperatively.
The procedure for breast reconstruction was modified to reduce donor site morbidity. Previously, breast reconstruction was generally performed using rectus abdominis musculocutaneous free flaps containing a large part of the rectus abdominis muscle, resulting in complications such as hernia or muscle weakness. This technique was modified to involve the use of a rectus abdominis muscle perforator flap without the muscle itself, thereby reducing donor site morbidity.
Other studies in the field of reconstructive surgery are being conducted in cooperation with other divisions such as the Division of Colorectal Surgery, the Division of Esophageal Surgery, etc.
● M. Sakuraba ●
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