中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (09): 752-755.

• 论著 • 上一篇    下一篇

背阔肌-胸大肌复合肌瓣即刻乳房再造研究

张 斌1 ，冯 锐2 ，葛 洁1 ，尹 健1，张学慧1，乔 群3 ，曹旭晨1   

  1. 1 天津医科大学附属肿瘤医院乳腺一科，天津300060; 2 天津市中心妇产科医院乳腺科，天津300052；3 中国医学科学院 中国协和医科大学 北京协和医院整形科，北京100730
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-09-01 发布日期:2009-09-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-09-01 Published:2009-09-01

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摘要：

目的 探讨乳腺癌经保留皮肤的乳房切除术后，采用基于胸背动脉降支的部分背阔肌肌瓣联合帆状胸大肌瓣组成复合肌瓣加假体植入即刻乳房再造的临床价值。方法 收集天津医科大学肿瘤医院和天津中心妇产科医院2006年1月至2009年3月采用上述手术方式进行乳房再造的15例病人（16侧乳腺癌）的临床资料，分析该术式的特点及适应证。结果 15例病人均成功应用上述术式进行乳房再造，术后3例出现皮瓣下血清肿，经抽吸后痊愈。14例浸润性乳腺癌病人均接受化疗，未发生相关并发症。中位随访16（2～36）个月，再造乳房形态良好，手感柔软，无假体包膜挛缩。结论 该术式简单，安全，手术时间短，保留了胸大肌和背阔肌的主要功能同时保护供区。适用不能或不愿保乳，术前术中评价不需要放疗的病人。

关键词: 乳腺癌, 即刻乳房再造, 背阔肌, 胸大肌, 复合肌瓣

Abstract:

Immediate breast reconstruction with partial latissimus dorsi and pectoralis major compound muscular flap ZHANG Bin*, FENG Rui, GE Jie, et al. Department of Breast Cancer, Cancer Hospital of Tianjin Medical University, Tianjin 300060, China. Corresponding author: CAO Xu-chen, E-mail: CXC@medmail.com.cn Abstract Objective To investigate immediate breast reconstruction following skin-sparing mastectomy in breast carcinoma patients by using thoracodorsal artery descending branche based partial latissimus dorsi and pectoralis major compound muscular flap with breast prothesis. Methods Breast reconstruction were performed in 16 patients with operation procedures described above, and the traits and indications of the procedure were analyzed. The patients were admitted between January 2006 and March 2009 at Cancer Hospital of Tianjin Medical University and Tianjin Central Hospital for Gynaecology and Obstetrics. Results Fifteen patients (16 breasts) underwent the breast reconstruction procedure following immediate mastectomy as described above. Three patients had experienced seroma, which was treated and cured by aspiration method. Forteen patients performed chemotherapy after being confirmed as invasive breast cancer by pathology and none of them had experienced relative complications. The median follow up time was 16 months (2～36 months), reconstructive breast demonstrated of good shape, soft texture, and without any capsular contracture. Conclusion Breast reconstruction with partial latissimus dorsi-pectoralis major compound muscular flap and breast prothesis is a simple and safe procedure, which reserved the functionof latissimus dorsi and pectoralis major and conserved the donor site. The procedures is suitable for the patients who were either inappropriate for or unable to comply with breast-conserving surgery and radiotherapy is not required in pre- and intra-operation evaluation.

Key words: breast cancer, immediate breast reconstruction, latissimus dorsi, pectoralis major, compound muscular flap