乳腺癌切除一期扩大背阔肌皮瓣乳房重建的应用及患者满意度评价  

Immediate breast reconstruction using an extended latissimus dorsi flap after skin-sparing mastectomy and evaluation of patient satisfaction

作　　者：严文辉[1,2] 周冬仙[1,2] 刘新杰[1,2] 邙建波[1,2] 张桂英[1,2] 周文斌[1,2] 许楠[1,2] 胡泓[1,2] 张雅媛[1,2] 

机构地区：[1]暨南大学附属第二医院 [2]深圳市人民医院乳腺外科,广东深圳518020

出　　处：《暨南大学学报（自然科学与医学版）》2013年第6期655-659,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：深圳市科技计划基金项目(200603067)

摘　　要：目的：总结乳腺癌保留皮肤全乳切除一期扩大背阔肌皮瓣乳房重建的临床经验，评估乳房重建后患者满意度。方法：回顾分析15例应用乳腺癌保留皮肤全乳切除一期扩大背阔肌皮瓣乳房重建病例的临床资料，并于术后半年调查患者满意度情况。结果：手术后无皮瓣坏死；无伤口感染；供区血清肿3例（20％），均经穿刺抽液治愈。随访时间8～30月，平均18.5月。采用满意度表调查，结果显示患者的总体满意度为73.3％，美容满意度为66.7％。结论：乳腺癌保留皮肤全乳切除一期扩大背阔肌皮瓣乳房重建是一种并发症少、患者满意度高的乳房重建方法。Aim：To evaluate the results of immediate breast reconstruction with an extended latissimus dorsi flap in patients with breast cancer following skin-sparing mastectomy and patient satisfaction in post-mastectomy reconstruction.Methods：The clinical data of the patients who had undergone immediate breast reconstruction with the latissimus dorsi flap after skin-sparing mastectomy from January 201 1 to January 201 3 were collected.The operative technical detail,postoperative complications and patient sat-isfactions were analyzed.Results：Fifteen patients with breast cancer underwent immediate breast recon-struction with the latissimus dorsi flap after skin-sparing mastectomy,including stage 0 （carcinoma in si-tu）,Ⅰ,Ⅱa in 6,5,4 patients respectively.The mean age was 33.5 years （range,25 ~42 years）. The length of following-up ranged from 8 to 30 months.There was no flap loss.Donor site seroma oc-curred in 3 patients （20%）,which disappeared after repeated aspiration.Wound infection wasn’t ob-served.Patient overall general satisfaction rate in postmastectomy reconstruction was 73.3% and patient overall aesthetic satisfaction rate was 66.7%.Conclusion：In selected patients with breast cancer the ex-tended latissimus dorsi flap based breast reconstruction after skin-sparing mastectomy is a relatively easy and reliable method.

关 键 词：乳腺肿瘤 乳房切除术 乳房成形术 

分 类 号：R655.8[医药卫生—外科学]