关键词: 乳腺癌, 带蒂降支背阔肌皮瓣, 即刻乳房重建, 临床效果

Abstract: To investigate the effect and value of latissimus dorsi flap with descending branch for immediate breast reconstruction for breast cancer. Methods    We retrospectively analyzed the clinical data of 25 patients admitted to our hospital from January 2021 to June 2022 who underwent immediate breast reconstruction using the tibial descending latissimus dorsi muscle flap for breast cancer (tibial descending group) and compared them with 28 patients who underwent immediate breast reconstruction using the traditional latissimus dorsi muscle (conventional group) during the same period to assess the clinical effects and conduct follow-up The clinical results were evaluated and followed up. Results    The hospitalization time of the patients in the group with descending branch was （5.7±1.0）d, and the time of extubation was （10.4±4.5）d after the operation; the hospitalization time of the patients in the conventional group was （6.5±1.1）d, and the time of extubation was （14.9±5.7）d after the operation. In the group with the descending branch, seroma occurred in the back of 2 patients, which was improved after local syringe aspiration, while in the conventional group, seroma occurred in the back of 5 patients, and in 2 cases, drainage time was prolonged by the reintroduction of tubes after extubation. Patient satisfaction was higher in the banded descending branch group than in the conventional group. Until April 2024, one patient in the banded descending branch group had local tumor recurrence 3 months after radiotherapy. Conclusion    Immediate breast reconstruction with a tipped descending latissimus dorsi flap is cosmetically effective, minimally injurious, but it should be chosen with caution in patients with a first diagnosis of cutaneous invasion or an average outcome after neoadjuvant chemotherapy.

Key words: breast cancer, latissimus dorsi flap with descending branch, immediate breast reconstruction, clinical effects