RESUMO
Oral cancer poses a significant health burden, particularly in the male population of India. This study focuses on evaluating the outcomes of 48 pedicled Pectoralis major myocutaneous (PMMC) flap reconstructions in male patients with oral malignancy. Given the challenges associated with microvascular flap reconstructions, especially in advanced cancer cases, older patients, and resource-constrained settings, the PMMC flap still serves as a valuable alternative. The study introduces a novel approach by incorporating a laterally based rotational advancement flap (LBRA) to address donor site integrity and decrease the nipple-areolar complex (NAC) displacement. Traditionally, PMMC flap designs tend to cause inward shifting of the NAC during chest donor site closure, impacting the aesthetic outcome. Surgical techniques involved wide local resection, neck dissection, and PMMC flap reconstruction. The Flap design included a horizontal orientation with adjustments based on defect location. Additionally, a laterally based rotational flap from the chest aided in donor site closure. Results demonstrate the versatility and reliability of PMMC flap reconstructions, with no total flap necrosis or major complications observed in the 48 cases. The LBRA technique effectively mitigated NAC displacement. The study contributes to the existing literature by providing insights into the advantages of PMMC flap reconstructions and introducing a technique to optimize donor site closure and decrease the medial shifting of the nipple. The adaptability, reliable vascular supply, and simplified learning curve make the PMMC flap a preferred choice in resource-constrained settings with high patient demand. In conclusion, this research underscores the continued relevance and effectiveness of the PMMC flap in head and neck reconstruction, offering satisfactory cosmetic and functional results. The introduction of the LBRA technique adds a nuanced dimension to improve outcomes, particularly in male patients with oral malignancy.
RESUMO
Background and aim Cancer poses a significant burden in India, with a considerable number of people living with the disease and a substantial increase in new cases every year. Hence, considering the unique challenges faced by developing nations regarding the disease burden, this study has been designed. The aim of this work was to carry out a descriptive retrospective cross-sectional study on various types of cancer conducted in a tertiary care centre in India. Methods One thousand cancer patients who attended the outpatient department (OPD) from tertiary care cancer hospitals from July 2019 to December 2023 in Eastern India were enrolled. Patients included were of either gender, with their demographic details and the disease duration, who visited the OPD of hospitals meeting the eligibility criteria. Exclusion criteria were terminally ill cancer patients and patients who did not visit the outpatient department of the studied site. Descriptive analysis and chi-square test were carried out using the SPSS statistical software, version 20.0 (IBM Corp., Armonk, NY) for data analysis. Ethics committee approval was taken. Results Gastrointestinal tract cancer (31.3%, n=313) and breast cancer (19.8%, n=198) were found to be the most common types of cancer among all. Out of the total patients studied, 41.1% were males and 58.9% were females. Among regions, North Chotanagpur had the highest (40.5%) prevalence, followed by South Chotanagpur (26.0%). The majority of individuals belonged to 41 to 60 years (49.0%, n=490), followed by 21-40 years (28.9%, n=289). Gastrointestinal cancer was more prevalent among males (35.5%, n=146), while breast cancer was predominant among females (31.4%, n=185). Conclusion Cancer is more prevalent among rural females (58.9%), providing valuable insights into the prevalence of various cancers and highlighting differences between regions, age groups, and genders.