侧胸壁筋膜瓣联合部分胸大肌筋膜瓣在乳房再造中的临床应用  

Clinical application of lateral chest wall fascia flap combined with partial pectoralis major myofascial flap in breast reconstruction

作　　者：辛建恺 孔令禹 孔滨 辛智芳 苏传付 谷兆鑫 XIN Jian-kai;KONG Ling-yu;KONG Bin;XIN Zhi-fang;SU Chuan-fu;GU Zhao-xin(Breast Center,Affiliated Hospital of Qingdao University,Qingdao 266071,China;First Department of Breast Tumor,Linyi Cancer Hospital,Linyi 276001,China)

机构地区：[1]青岛大学附属医院乳腺中心,山东青岛266071 [2]临沂市肿瘤医院乳腺一科,山东临沂276001

出　　处：《中华肿瘤防治杂志》2022年第3期198-202,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨应用侧胸壁筋膜瓣联合部分胸大肌筋膜瓣覆盖假体在即刻乳房重建中的可行性和安全性。方法选择临沂市肿瘤医院乳腺科2017-08-30-2020-09-30进行保留乳头乳晕皮下腺体切除同时行即刻乳房重建的60例早期乳腺癌患者为研究对象,对患者切口并发症、局部复发、远处转移及术后美容效果进行评估。结果术后随访3~40个月,中位随访17个月,无1例出现局部复发和远处转移。术后8例切口红肿,3例皮缘缺血,2例切口裂开,经积极对症处理后均痊愈,无假体取出等严重并发症。术后外观及患者满意度评价优39例,良16例,一般5例,优良率为91.7%。结论在早期乳腺癌患者中,侧胸壁筋膜瓣联合部分胸大肌筋膜瓣覆盖假体的即刻乳房重建手术操作简单,同时采用筋膜瓣制备过程中形成的创腔固定假体,可防止假体移位,并发症少,美容效果好,是一种安全可行、经济实用的重建方法。Objective To investigate the feasibility and safety of using lateral chest wall fascia flap combined with partial pectoralis major myofascial flap to cover the prosthesis in immediate breast reconstruction.Methods A total of 60 patients with early breast cancer who underwent immediate breast reconstruction in the breast department of Linyi Tumor Hospital from August 1,2017 to September 30,2020 were selected to evaluate the incision complications,local recurrence,distant metastasis and postoperative cosmetic effect.Results The postoperative follow-up was 3 to 40 months,and the median follow-up was 17 months.There was no local recurrence or distant metastasis in any case.After operation,8 cases of incision were red and swollen,3 cases of skin edge ischemia,2 cases of incision dehiscence,all recovered after active symptomatic treatment,no serious complications such as prosthesis removal.Postoperative appearance and patient satisfaction were evaluated as excellent in 39 cases,good in 16 cases,and fair in 5 cases,with an excellent and good rate of 91.7%.Conclusion In patients with early breast cancer,immediate breast reconstruction surgery with lateral chest wall fascia flap combined with partial pectoralis major fascial flap covering the prosthesis is simple and easy to operate.Displacement,less complications,good cosmetic effect,is a safe,feasible,economical and practical reconstruction method.

关 键 词：乳腺癌 即刻乳房再造 假体 侧胸壁筋膜瓣 胸大肌筋膜瓣 

分 类 号：R737.9[医药卫生—肿瘤]