Abstract:

Indications and technical principles of latissimus dorsi myocutaneous flap breast reconstruction        YANG Yan-wen，QI Fa-zhi. Department of Plastic Surgery，Zhongshan Hospital of Fudan University，Shanghai 200032，China
Abstract    Latissimus dorsi musculocutaneous flaps can be used for delayed or immediate breast reconstruction. It can be used in combination with the prosthesis. Latissimus dorsi flap combined with breast prosthesis is recommended for the repair of large local defects after mastectomy and axillary lymph node dissection. For patients who can not use rectus abdominis flap due to abdominal surgery or abdominal diseases, latissimus dorsi flap is the first choice for breast reconstruction. However, the flap shouldn’t be used if surgeons suspect any problems of thoracic dorsal artery, subscapularis artery or latissimus dorsi muscle. Comprehensive evaluation and aesthetic design are needed before operation.

Key words: breast reconstruction, latissimus dorsi musulocutaneous flap

摘要：

无论是延迟乳房重建还是即刻乳房重建，均可以应用背阔肌肌皮瓣来进行。它既可以单独使用，也可结合假体同时应用于乳房重建。对于乳房切除、腋窝淋巴结清扫术后局部缺损较大的病人，背阔肌肌皮瓣结合乳房假体的乳房重建手术是一种非常好的选择。对于因为腹部手术、腹部疾病等问题，不能采用腹直肌肌皮瓣进行乳房重建的病人，首选背阔肌肌皮瓣重建乳房。但如果不能排除胸背动脉、肩胛下动脉以及背阔肌损伤可能则应该避免采用背阔肌肌皮瓣乳房重建。术前应对背阔肌肌皮瓣进行全面评估及仔细设计，术中谨慎操作，注意避免发生术中及术后并发症。

关键词: 乳房重建, 背阔肌肌皮瓣