保留胸背神经背阔肌皮瓣在乳腺癌保乳术后乳房缺损中的应用  

Application of latissimus dorsi-myocutaneous flap in repairing breast partial defect without excising thoracodorsal nerve

作　　者：陈增红[1] 曹东升[1] 谢娟[1] 李红红[1] 娄寅[1] 朱邦中[1] 

机构地区：[1]安徽医科大学第二附属医院整形外科,安徽合肥230601

出　　处：《中国美容医学》2014年第18期1497-1500,共4页Chinese Journal of Aesthetic Medicine

基　　金：安徽省临床医学重点学科应用技术项目(计划编号:05A012)

摘　　要：目的:探讨保留胸背神经背阔肌皮瓣在早期乳腺癌保乳术后乳房缺损中的应用价值。方法:术中解剖胸背神经至见到内侧支和外侧支,将内侧支与外侧支分离,离断外侧支保留内侧支。应用保留胸背神经背阔肌皮瓣对早期乳腺癌保乳术后乳房缺损进行修复,并对术后效果进行美学评估。结果:16例乳房缺损背阔肌皮瓣全部成活,无严重术后并发症。1例修复乳房早期形态及大小良好,因受放疗影响晚期出现挛缩,患者自我感觉不满意,再次手术置入假体重新塑形后效果满意,其余15例术后外形及感觉良好,患者均满意。美学评估结果:良6例,中9例,差1例。结论:保留胸背神经背阔肌皮瓣行乳房缺损修复操作简单、耗时短、术后并发症少,是一种适用于早期乳腺癌保乳术后乳房缺损的修复方法。Objective To evaluate the results of repairing breast partial defect after breast conservation using latissimus dorsi-myocutaneous flap without excising the medial branche of thoracodorsal nerve. Methods Through upward dissection the nerve from the first class branches of thoracodorsal nerve, which were the medial and lateral branches.Cut the lateral branches without excising the medial branche of thoracodorsal nerve,and then the latissimus dorsi-myocutaneous flap was used for repairing breast partial defect, at the last the aesthetic results were assessed.Results Among the 16 patients,there is no flap losses and no severe complication.Only one of patients felt dissatisfaction, because the shape and the size of postoperative breast was undesirable after radiation treatment, which was repaired combined breast implant inserted in re-operation, the others 15 patients was very satisfaction with the aesthetic result of perfect appearance, shape and sensation. The aesthetic results：there are 6 excellent cases,9 average cases and 1 failed cases according to the aesthetic results were assessed.Conclusion The method of repairing breast partial defect is suitable for the females after breast conservation with the advantage of simple operation and low complication.

关 键 词：背阔肌皮瓣 胸背神经 乳房缺损 保乳术 

分 类 号：R622.9[医药卫生—整形外科]