腹腔镜获取游离大网膜在乳房重建中的应用研究进展  

Research progress in the application of laparoscopic access to free greater omentum in breast reconstruction

作　　者：陈英毓 李建文 黄胜超 CHEN Yingyu;LI Jianwen;HUANG Shengchao(The First Clinical Medical College,Guangdong Medical University,Guangdong Province,Zhanjiang524000,China;Department of Vascular,Thyroid and Breast Surgery,Affiliated Hospital of Guangdong Medical University,Guangdong Province,Zhanjiang524000,China)

机构地区：[1]广东医科大学第一临床医学院,广东湛江524000 [2]广东医科大学附属医院血管甲状腺乳腺外科,广东湛江524000

出　　处：《中国当代医药》2023年第18期36-40,共5页China Modern Medicine

摘　　要：腹腔镜获取游离大网膜的乳房重建是乳房切除后自体组织重建乳房的一种方式。由于大网膜组织有丰富的血管、淋巴和脂肪组织,具有较好的抗感染、吸收、缺血时再生和免疫功能等特性,生存能力强,并且大网膜质地柔软、容易塑形,可以应用于乳房重建,重建乳房外观自然、手感柔软和真实。早期需要开腹获取大网膜,腹部创伤大及术后并发症多,限制其在临床上推广。随着腹腔镜和显微镜技术的微创优势使得获取游离大网膜可回收、腹部创伤小、并发症少、术后恢复快等优点,使腹腔镜获取游离大网膜在乳房重建方面较其他自体组织更加有吸引力。本文针对大网膜解剖,大网膜在乳房重建中的发展,游离大网膜进行乳房重建的适应证、手术过程、常见并发症及处理、优缺点进行综述,旨在增加对游离大网膜应用于乳房重建的认识及在临床推广。Laparoscopic breast reconstruction with free omentum is a way of breast reconstruction with autologous tissue after mastectomy.Because the greater omentum tissue is rich in blood vessels,lymph and adipose tissue,it has good characteristics of anti-infection,absorption,regeneration during ischemia and immune function,and has strong viability.In addition,the omentum is soft and easy to shape,and can be applied to breast reconstruction,and the reconstructed breast has a natural appearance,soft and real hand feeling.Early laparotomy is required to obtain greater omentum,and abdominal trauma and postoperative complications limit its clinical application.With the minimally invasive advantages of laparoscopy and microscopy,the free omentum obtained by laparoscopy can be recovered,with less abdominal trauma,fewer complications and faster postoperative recovery,which makes the free omentum obtained by laparoscopy more attractive than other autologous tissues in breast reconstruction.In this paper,the anatomy of greater omentum,the development of greater omentum in breast reconstruction,indications,surgical procedures,common complications,treatment,advantages and disadvantages of free greater omentum in breast reconstruction are reviewed,aiming at increasing the understanding and clinical promotion of free greater omentum in breast reconstruction.

关 键 词：腹腔镜技术 游离大网膜组织 自体组织 乳房重建 

分 类 号：R655.8[医药卫生—外科学]