Department of Plastic and Reconstructive Surgery

Takuya Higashino, Azusa Oshima, Shuchi Azuma, Takeaki Hidaka, Ryosuke Matsusaka, Sho Suzuki, Daiju Goto, and Ryota Imamura

Introduction

The Department of Plastic and Reconstructive Surgery has mainly focused on surgical reconstruction following cancer ablation. In our institution, reconstructive procedures using vascularized free tissue transfer with microvascular anastomosis are the most important operations. In addition, several methods such as tissue transfer with pedicled flaps, local flaps, and skin grafting are used for reconstructive surgery. The objectives of reconstructive surgery are not only the morphological reconstruction, but also the restoration of postoperative functions after ablative surgery. The quality of life (QOL) of patients can be improved with functional and morphological reconstruction.

The Team and What We Do

Three plastic surgeons cover reconstructive operations in the National Cancer Center Hospital (NCCH) East in Kashiwa. The reconstructive surgeries are performed in cooperation with surgeons of other departments within the hospital, such as the Departments of Head and Neck Surgery, Breast Surgery, Esophageal Surgery, Thoracic Surgery, and Colorectal Surgery (Table 1). In addition, the Department of Musculoskeletal Oncology was established in April 2021, and reconstructive surgery after resection of bone and soft tissue tumors was started.

In the NCCH East, head and neck reconstruction is the most frequently performed operation accounting for approximately 50% of the reconstructive surgeries. Free jejunal transfer, anterolateral thigh flap transfer, and rectus abdominis musculocutaneous flap transfer are the frequently used procedures in the head and neck region (Table 2). A weekly conference is held with doctors of the Departments of Head and Neck Surgery, Radiation Oncology, and Head and Neck Medical Oncology. Breast reconstruction using autologous tissue transfer was employed in 2003. Since then, patients’ needs for breast reconstruction have increased. Furthermore, lymphatico-venular anastomosis as a surgical treatment for lymphedema of the extremities was introduced in 2013.

Table 1. Number of surgeries

Fiscal year	2019	2020	2021	2022	2023	2024
Total	230	226	266	220	218	234
Head and neck recoustruction	109	116	97	82	92	109
Breast reconstruction	39	37	54	37	46	57
Esophageal surgery-realated	27	24	27	14	10	14
Thoracic surgery-related	2	4	4	4	3	3
Colorectal surgery-related	8	4	7	10	23	11
Hepatobiliary and pancreatic surgery-related	0	1	1	1	2	0
Musculoskeletal oncology-related	0	0	10	12	0	0

 

Research activities

Plastic and reconstructive surgery has focused on the following four aspects in the surgical treatment of cancer for the purpose of contributing to improving patients’ QOL: 1) obtaining good functional recovery,2) reducing postoperative complications,3) achieving less donor site morbidity, and 4) treating postoperative complications after cancer ablation.With the objective of addressing these four aspects, establishing a standard for reconstructive surgery and developing new techniques of reconstructive surgery are the most important aims of our studies. In 2017, we started to take an active role in a new multi-institutional analysis of risk factors for functional outcomes after tongue reconstruction.

Education

We accept a large number of young plastic surgeons from all over Japan as residents and train them to become reconstructive surgeons. We also train them to become future opinion leaders in the field of reconstructive surgery.

Future prospects

The promotion of multi-institutional studies on reconstructive surgery will provide our patients with high-precision and evidence-based medical services.

List of papers published in Fiscal year 2024

Journal