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プランタルメラノーマに対する外科再建アプローチの合併症の評価:体系的なレビューとメタ解析
Noah M Scigliano1, Nicholas M Scigliano, Yumeng Gao
1From the Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, IA.
Annals of plastic surgery
|August 27, 2025
まとめ
フリーフラップ,ペディクルフラップ,または皮膚移植による足底メラノーマの欠陥の再構築は,同様の合併症率を示しました. 最適な選択は 合併症のリスクだけでなく 患者と腫瘍の因子にも 依存します
科学分野:
- 整形 術
- 手術腫瘍学
- 皮膚科
背景:
- 足の重荷を負う機能と 独特の柔らかい組織のため 足のメラノーマの再建は複雑です
- 最適な再建には 機能的な回復を保証し 合併症を最小限に抑えるための 慎重な計画が必要です
研究 の 目的:
- フリーフラップ,ペディクルフラップ,皮膚移植の3つの足底メラノーマの欠陥再建方法の合併症率を体系的にレビューし,メタ分析する.
主な方法:
- 2000年から2023年の間にOvid MEDLINE,EMBASE,Cochrane CENTRALで発表された研究の体系的なレビューとメタ分析.
- 定性分析のための19の研究と定量分析のための14の研究,合計159の再構築手順が含まれています.
- 合併症率を比較するために逆方差法を用いた比較分析.
主要な成果:
- フリーフラップ,ペディクルフラップ,皮膚移植の全体的な合併症発生率,全体的な合併症,またはフラップ喪失/ネクロス率の有意な差異は認められなかった (P > 0. 05).
結論:
- 合併症データを集約した結果,足のメラノーマの欠陥に対する再構築の選択肢は1つでもありません.
- 再構築の決定は,腫瘍の特徴 (サイズ,深さ),血管の状態,重量帯域に対する解剖学的位置を考慮する必要があります.
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