Plastic and Reconstructive Surgery

Introduction

The Plastic and Reconstructive Surgery Division is primarily focused on surgical reconstruction after cancer ablation. Reconstructive procedures using free flap transfer with microvascular anastomosis are the most important operations performed by the Division. Moreover, several methods such as tissue transfer with pedicled flap, local flap or skin graft are used for reconstructive surgery. The aims of reconstructive surgery include not only morphological reconstruction but also the restoration of postoperative function after ablative surgery. The quality of life (QOL) of a patient can thus be improved by functional and morphological reconstruction.

Routine Activities

Three plastic surgeons perform reconstructive operations and train residents both in the NCCH East in Kashiwa and the NCCH in Tokyo. Three to four reconstructive operations are performed weekly in cooperation with surgeons from other hospital divisions, such as the Head and Neck Surgery, Orthopeadic Surgery, Esophageal Surgery, Breast Surgery, and Colorectal and Urological Surgery Divisions. Head and neck reconstruction is the most frequently performed operation, accounting for 68% of all reconstructive surgeries. In the head and neck region, a free jejunum graft and a rectus abdominis musculocutaneous flap are the most frequently used procedures.

● M. Sakuraba ●

Type and number of surgical procedures performed in cooperation with other divisions
  NCCH East NCCH Tokyo Total
  Head & Neck surgery
  Orthopeadic surgery
  Esophageal surgery
  Breast surgery
  Dermatology
  Urologic surgery
  HB&P surgery
  Ophthalmic surgery
  Colorectal surgery
  Gastric surgery
  Thoracic surgery
  Gynecologic surgery		156
----
5
10
----
2
0
----
4
0
4
----		53
25
4
2
2
0
1
0
1
3
0
4		209
25
9
12
2
2
1
0
5
3
4
4
  Total 181 95 276
HB&P: Hepatobiliary and pancreatic

Operative procedure
  NCCH East NCCH Tokyo Total
Microvascular free flaps 135 51 186
  Jejunum
  RAMC
  Anterolateral thigh
  Fibula bone
  Latissimus dorsi
  Radial forearm
  Other flaps		51
41
23
9
3
2
6		17
12
11
5
3
2
1		68
53
34
14
6
4
7
Other Microsurgeries 3 6 9
  Supercharge
  Nerve graft
  Limb salvage
  Hepatic artery
  Others		0
2
0
0
1		1
0
3
2
0		1
2
3
2
1
Subtotal 138 57 195
Pedicled flaps 25 19 44
  PMMC
  Latissimus dorsi
  RAMC
  Other flaps		14
3
1
7		4
5
2
8		18
8
3
15
Other procedures 23 19 42
Total 186 95 281
RAMC: Rectus Abdominis Musculocutaneous
PMMC: Pectoralis Major Musculocutaneous

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