腹部横行小切口游离带蒂大网膜在一期乳房成形中的应用  

Pedicle greater omentum dissection through a small transverse abdominal incision in an immediate breast reconstruction

作　　者：韩明玥[1] 于伟杰[1] 邱晓冬[1] 王洪武[1] 郭俊杰[1] 刘翠萍[1] 

机构地区：[1]赤峰学院附属医院乳腺外科,内蒙古赤峰024000

出　　处：《中华乳腺病杂志（电子版）》2012年第6期28-31,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨腹部横行小切口游离带蒂大网膜在一期乳房成形中的应用效果。方法选择赤峰学院附属医院乳腺外科2007年1月至2011年5月收治的早期乳腺癌或癌前期病变患者19例,术中即刻行腹部横行小切口游离带蒂大网膜一期乳房成形术。结果 19例患者术后组织瓣均全部成活。术后随访3个月至5年,中位随访时间为20个月。本组患者中,17例重建乳房自然、柔软、外观形态良好,患者十分满意;1例切口边缘皮瓣坏死、裂开,网膜瓣部分坏死、吸收,重建乳房外形小、欠佳;1例患者偏瘦,网膜瓣少,重建乳房外形小,网膜瓣蒂短、轻度下移,双乳不对称,效果差。结论早期乳腺癌或癌前期病变患者术中即刻行腹部横行小切口游离带蒂大网膜一期乳房成形术,具有安全、经济、实用、美观等诸多优点,且不影响肿瘤术后的综合治疗及随访。Objective To investigate the application and effect of pedicle greater omentum dissection through a small transverse abdominal incision in an immediate breast reconstruction. Methods From January 2007 to May 2011, 19 early breast cancer or precaneerous patients were selected to undergo intraoperative immediate breast reconstruction with pedicle greater omentum by a small transverse abdominal incision. Results After operation, tissue flap all survived in 19 cases. The follow-up time was 3 months to 5 years （median： 20 months）. In 17 cases of this group, the reconstructed breasts presented a natural, soft and good appearance, which the patients were very satisfied with. Besides, in one case, skin flap of incision edge was necrosed and cracked, with greater omental flap partially necrosed and absorbed, leading to a small and poorly shaped breast; the other one patient was over-slim, with less greater omental tissue, so the reconstructed breast was small, the pedicle of omentum flap was short and downwards, resulting in an asymmetric and poorly reconstructed breast. Conclusions The pedicle greater omentum is dissected through a small transverse abdominal incision to perform an immediate breast reconstruction for early breast cancer or precancerous patients. This approach of breast reconstruction has the advantages of safety, economy, applicability and good appearance, with no influence on postoperative combined therapy and follow-up.

关 键 词：乳房成形术 大网膜 腹部小切口 

分 类 号：R737.9[医药卫生—肿瘤]