Our concepts in reconstruction after cancer surgery.

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Our basic concept of reconstruction after cancer surgery is presented. The goal of plastic and reconstructive surgery in this field is to maintain the patient's quality of life by giving him back what he lost by cancer itself or cancer surgery. From this point of view, primary reconstruction could be widely indicated not only for functional reconstruction but also for morphological reconstruction such as breast reconstruction and safety of this procedure is discussed. The problem of concealing cancer recurrence by flap is also discussed and we concluded that the possibility of hiding a recurrence is very low whereas this procedure could be beneficial to the patient as a palliative treatment providing psychological relief. At Keio University Hospital and her affiliated hospitals, 259 cases of recon-structive procedures using flaps are reviewed. Of these flaps 129 cases are free flaps transfers with microvascular anastomosis and 83% of these flaps are applied in the head and neck region. In other regions, pedicled musculocutaneous and fasciocutaneous flaps are mainly used. In our series free jejunum transfer is the main method for pharyngoesophageal reconstruction and repair of the oral mucosa. The flap selection for reconstruction of other sites, i.e., the scalp, the orbita, the mandible, the skin of the face and neck, the cheek (after total maxil-lectomy), cervical and thoracic esophagus, chest wall, breast and the skin of the groin, perineun and penis is individually reviewed. A few examples of clinical applications are presented.

Our concepts in reconstruction after cancer surgery.

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