保留部分前鞘的TRAM瓣在乳腺癌同期乳房再造中的应用  

Clinical application of transverse rectus abdominis musculocutaneous flap reserving partial anterior sheath TRAM-RPAS） in the one-stage breast reconstruction for patients with breast cancer

作　　者：刘小蕉[1] 叶秀娣[2] 王萃[2] 虞渝生[2] 

机构地区：[1]浙江大学附属第一医院普外科,杭州310006 [2]浙江大学附属第一医院整形科,杭州310006

出　　处：《中华整形外科杂志》2008年第4期291-293,共3页Chinese Journal of Plastic Surgery

摘　　要：目的对乳腺癌患者采用保留部分前鞘的下腹部横行腹直肌肌皮瓣（TRAM瓣）进行一期乳房再造，并探讨降低术后腹壁疝、腹壁膨出发生率的方法。方法对2002至2004年接受乳腺癌根治术的16例患者（一、二期9例，三期7例），于根治术同期采用保留部分前鞘的TRAM瓣术式再造乳房。结果本组16例再造乳房与对侧基本对称12例，不对称的4例中，3例为对侧乳房中度以上下垂，1例为再造乳房偏小。术后随访平均2年5个月，所有病例的TRAM瓣均存活，仅1例发生腹壁膨隆。结论部分筋膜法TRAM瓣一期再造乳房，可保持传统TRAM瓣手术的效果并能降低术后腹壁并发症发生率。Objective To investigate the clinical application of TRAM-RPAS flap in the one-stage breast reconstruction for patients with breast cancer, and to discuss the method to reduce the incidence of abdominal hernia and abdominal bulging. Methods From 2002 to 2004, 16 cases of breast cancer （9 cases in stage I or n and 7 in stage m ） received radical resection and breast reconstruction with TRAM-RPAS flaps at the same stage. Results Good symmetry was achieved in 12 cases, In the other 4 cases, 3 cases had moderate breast poptosis and one case had breast hypoplasia on the unaffected side. All the flaps survived with only one case of abdominal bulging. Conclusions TRAM-RPAS flap can achieve the same result as traditional TRAM-RPAS flap in the one-stage breast reconstruction, while the incidence of abdominal complication is lower for TRAM-RPAS flap.

关 键 词：外科皮瓣 乳房成形术 临床分析 治疗方法 

分 类 号：R737.9[医药卫生—肿瘤]