应用邻近扩张皮瓣修复T4期局部晚期乳腺癌术中大面积软组织缺损的临床研究  

Adjacent expanded skin flap for large soft tissue defect in T4 locally advanced breast cancer

作　　者：寇晓梅[1] 柯永莉[1] 张晨芳[1] 李燕[1] 喻兰雅[1] 李黎[1] 

机构地区：[1]广州军区广州总医院普通外科,510010

出　　处：《临床外科杂志》2016年第9期675-677,共3页Journal of Clinical Surgery

基　　金：广东省科技计划资助项目(2009B060700064)

摘　　要：目的在皮肤累及较大的局部晚期乳腺癌根治术中应用邻近扩张皮瓣修复胸壁大面积缺损,减少术后并发症,降低局部复发率。方法 64例新辅助化疗完全缓解(complete remission,CR)、部分缓解(partial remission,PR)的患者,在新辅助化疗同期行患侧乳房周围皮下扩张器置入术,并持续液压扩张皮肤至化疗结束,行乳腺癌根治术同期取扩张器,推进扩张皮瓣修复创面。37例同期游离植皮修复患者为对照组。结果 64例采用扩张皮瓣的患者术后伤口全部一期愈合,术后放疗未出现皮肤放射性溃疡,随访3年局部复发率明显低于游离植皮组。结论对于新辅助化疗有效的T4期乳腺癌患者,根治术中应用邻近扩张皮瓣修复可减少皮瓣坏死和放射性溃疡的发生,降低局部复发率。Objective To reduce the complications and local recurrence with adjacent expanded skin flap for large soft tissue defect in T4 locally advanced breast cancer. Methods Patients with com-plete remission or partial remission after neoadjuvant chemotherapy were enrolled in this work. Prefabrica-ted expanded skin flap was implanted in patients of the observation group. Free skin grafting was used in other patients as controls. Results All incisions were primarily healed without radiation-induced ulcera-tion in sixty-four patients with expanded skin flap. The local recurrence rate was significantly lower than the controls after a follow-up of three years. Conclusion The rate of skin flap necrosis,post-radiation ul-cer,local recurrence can be reduced in advanced breast cancer patients treated with neoadjuvant chemo-therapy by adjacent expanded flap.

关 键 词：局部晚期乳腺癌 扩张皮瓣 组织修复 

分 类 号：R737.9[医药卫生—肿瘤]