扩大背阔肌肌皮瓣在乳腺癌改良根治术后一期乳房再造中的应用  

Application of Extended Latissimus Dorsi Flap in Immediate Breast Reconstruction after Modified Radical Mastectomy

作　　者：王亚兵[1] 陈剑平[1] 陈斌[1] 

机构地区：[1]皖南医学院附属弋矶山医院颈乳外科,安徽芜湖241001

出　　处：《中国普外基础与临床杂志》2010年第7期735-738,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的评价扩大背阔肌肌皮瓣在乳腺癌改良根治术后一期乳房再造中的应用价值。方法选取我科2008年1月至2009年6月期间收治的48例乳腺癌患者,根据所接受的术式分为扩大背阔肌肌皮瓣一期乳房再造(乳房再造)组(n=12)和单纯乳腺癌改良根治术(单纯根治)组(n=36),对2组患者术后并发症、恢复情况以及生活质量进行对比,并对再造乳房外观形态进行评价。结果乳房再造组患者均成功行扩大背阔肌肌皮瓣乳房再造,再造乳房外形评价良好6例,中4例,差2例,明显优于单纯根治组(P<0.001)。2组患者术后积液、皮瓣坏死、患肢及肩关节活动、住院时间、引流时间及开始辅助治疗时间差异均无统计学意义(P>0.05),但乳房再造组术后生活质量较好,与单纯根治组比较差异有统计学意义(P<0.001)。乳房再造组有10例行术后辅助放化疗,未出现转移皮瓣坏死。2组患者随访2～17个月(中位时间8个月),未见局部复发及转移。结论乳腺癌根治术后扩大背阔肌肌皮瓣一期再造乳房形态效果良好,手术操作简单,对早期乳腺癌是一种安全、可行的治疗方法 。Objective To evaluate the value of extended latissimus dorsi flap （ELDF） in immediate breast reconstruction in patients with breast cancer after modified radical mastectomy. Methods Thirty-six patients with breast cancer who accepted modified radical mastectomy and 12 patients with breast cancer who accepted immediate breast reconstruction after modified radical mastectomy from January 2008 to June 2009 were included. The compti cations, cosmetical results and quality of life of these patients were compared. The shape of breast reconstruction was also evaluated. Results All of 12 patients succeeded in proceeding immediate breast reconstruction with ELDF. The evaluation of shape of breast reconstruction was good in 6 cases, secondary in 4 cases, and bad in 2 cases, which was beyond that in patients of radical operation group （P〈0. 001）. There was no statistical difference in oper ation complications as hydrops, necrosis, affecting limb shoulder joint motion, drainage time, hospital stay, and starting time for adjuvant therapy between two groups （P〉0.05）. The patients in breast reconstruction group had a better quality of life compared with the patients in radical operation group （P〈0. 001）. In breast reconstruction group, 10 patients received adjuvant chemoradiotherapy and no necrosis was showed in local flap grafting. After the follow-up of 2-17 months （median 8 months）, no local recurrence and metastasis was demonstrated in two groups patients. Conclusions There are good cosmetic results after immediate breast reconstruction with EI.DE, and it is easy to operate. It is a safe and feasible therapeutics method for early breast cancer.

关 键 词：乳腺癌 改良根治术 扩大背阔肌肌皮瓣 一期乳房再造 

分 类 号：R737.9[医药卫生—肿瘤]