侧胸壁脂肪筋膜瓣在乳腺外科手术中的应用  

Clinical application of lateral thoracic wall adipofascial flap in immediate mammoplasty

作　　者：王圣应[1] 洪士开[1] 郑绪才[1] 高红[1] 刘松[1] 赵源源[1] 

机构地区：[1]安徽省肿瘤医院乳腺诊治中心,230088

出　　处：《中华内分泌外科杂志》2015年第5期356-359,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的：探讨应用侧胸壁脂肪筋膜瓣即刻乳房成形的手术适应证、疗效及可行性。方法回顾性分析26例保留乳头乳晕复合体的乳腺癌改良根治术及5例乳腺大区段切除术后应用侧胸壁脂肪筋膜瓣修复乳房外形的患者临床病理资料，其中乳腺癌患者在保留乳头乳晕复合体改良根治术中采用侧胸壁脂肪筋膜瓣修复乳房外形22例，采用侧胸壁脂肪筋膜瓣联合假体植入乳房重建4例。术后据主客观标准评价重建效果。结果24例乳腺癌患者术后乳房外形良好，双侧乳房基本对称。无皮瓣及乳头坏死。术后给予常规化疗，随访2～12个月，均无局部复发或远处转移。5例乳腺良性疾病术后乳房外观优良，患者较满意。结论对行保留乳头乳晕复合体的乳腺癌改良根治术的早期乳腺癌及乳腺大区段切除的乳腺良性疾病患者，应用侧胸壁脂肪筋膜瓣整复重建乳房外形，具有经济、操作可行、无附加切口、外形良好、减少乳房缺失带来的负面心理影响等优点，值得临床推广应用。Objective To explore the operative indication , therapeutic effects and feasibility of immedi-ate mammoplasty with lateral thoracic steato-fascia flap.Methods A retrospective study was carried out on clini-copathologic data of 26 patients receiving nipple-areola complex preserving modified radical mastectomy and im-mediate mammoplasty with lateral thoracic wall adipofascial flap and 5 patients receiving segmental mastectomy and immediate mammoplasty with lateral thoracic wall adipofascial flap because of benign breast diseases .In these patients receiving nipple-areola complex preserving modified radical mastectomy , 22 patients received lateral tho-racic wall adipofascial flap , and 4 patients received lateral thoracic wall adipofascial flap combined with silicone prosthesis .The surgical complications and cosmetic effects were evaluated by both subjective and objective stand -ard postoperatively .Results 24 patients were satisfied with the appearance of their breasts and the two sides seemed to be symmetrical .There was no flap or nipple necrosis .The patients received adjuvant chemotherapy after surgery.No local recurrence or distant metastasis occurred during the follow up （2 to 12 months）.Five patients with benign breast diseases were very satisfied with their breast appearance after surgery .Conclusion For patients in early stage breast cancer receiving modified radical mastectomy with nipple-areolar complex preserved and patients with benign breast diseases having segmental mastectomy , immediate mammoplasty with lateral thoracic wall adipo-fascial flap is a good method which can help to keep well breast apperance without additional incision , and it is also economical , feasible , and can reduce patients＇psychological pressure due to loss of the breast .

关 键 词：侧胸壁脂肪筋膜瓣 乳房成形 保留乳头乳晕复合体 乳腺癌改良根治术 乳腺区段切除术 

分 类 号：R737.9[医药卫生—肿瘤]