腹部游离皮脂肪筋膜瓣在保乳术缺损修复中的应用现状  

Application status of defect repair of abdominal free dermal fat graft in breast-conserving surgery

作　　者：赵烨 赵菁[1] 王亚军[1] 康骅[1] ZHAO Ye;ZHAO Jing;WANG Yajun;KANG Hua(Center for Diagnosis and Treatment of Thyroid and Breast Diseases,Xuanwu Hospital,Capital Medical University,Beijing100053,China)

机构地区：[1]首都医科大学宣武医院甲状腺乳腺疾病诊疗中心,北京100053

出　　处：《中国医药导报》2020年第26期30-33,共4页China Medical Herald

基　　金：北京市卫生系统高层次卫生技术人才学科带头人培养项目(2011-2-28)。

摘　　要：对于早期乳腺癌,肿瘤治疗的安全性与术后乳房外形的兼顾是医患双方共同追求的目标。目前,保乳手术乳房缺损的整复主要依靠乳腺肿瘤整形技术,即乳腺腺体移位法和自体组织瓣替代法。由于亚洲女性乳房体积整体偏小,肿瘤切除后的腺体缺损往往难以通过腺体移位弥补,应用自体组织填充缺损变形的乳房,可获得较好的美容效果。但既往尝试的背阔肌肌瓣、横行腹直肌肌皮瓣、腹壁下动脉穿支皮瓣等由于手术难度大,需专业显微外科技术而难以广泛开展。日本学者Kijima率先在临床上应用腹部游离脂肪皮瓣修复乳房缺损,术后美容效果好且手术操作简单,有望在临床上推广。但该术式目前开展时间尚短,仍需长期大样本量随访对其术后远期美容效果、并发症等进行科学评估。For early-stage breast cancer,both the safety of tumor treatment and the breast shape after surgery are the same goals pursued by doctors and patients.At present,the repairing of tissue defect after breast-conserving therapy mainly depends on oncoplastic breast surgery techniques,including glands displacement and autologous tissue breast replacement.Because the breast size of the Asian women are not big enough to undergo repairing by simple glands displacement after breast-conserving surgery,using an autologous tissue to fill up the defect can produce good cosmetic outcomes.However,the latissimus dorsi muscle flap,transverse rectus abdominis-myocutaneous flap,inferior abdominal artery perforator flap,and so on,which have been tried in the past,are difficult to carry out due to the difficulty of surgery and requirement of professional microsurgical techniques.Japanese scholar Kijima is the first one who use an autologous free dermal fat graft for breast defect tissue repair,which shows good cosmetic outcomes and simple to operating.This method is expected to be promoted clinically.Due to the short history of this operation,it still needs a long-term follow-up with large samples to scientifically evaluate the long-term postoperative cosmetic outcomes and complications.

关 键 词：乳腺癌 保乳手术 腹部游离脂肪皮瓣 整形技术 

分 类 号：R737.9[医药卫生—肿瘤]