带蒂侧胸穿支皮瓣在保乳整形手术中的应用  

Application of pedicled lateral perforator flap in breast conserving plastic surgery

作　　者：谢丽 高纪东 XIE Li;GAO Jidong(Department of Breast Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital&Shenzhen Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Guangdong Province,Shenzhen518000,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院深圳医院乳腺外科,广东深圳518000

出　　处：《中国当代医药》2024年第5期192-195,共4页China Modern Medicine

基　　金：中国医学科学院肿瘤医院深圳医院青年启动基金项目(SZ2020QN008)。

摘　　要：女性乳腺癌发现较晚,保乳术后乳房缺损大,术后容易导致乳房畸形,这是导致保乳率低的一个非常重要的因素。侧胸皮瓣作为自体皮瓣的一种,用于保乳整形术中,不失为一种实用的新型皮瓣。通过文献调研,本文总结了侧胸皮瓣应用于乳腺癌保乳整形手术的临床场景,包括乳房外上象限、外下象限、中央区的缺损修复,可采用侧胸筋膜组织瓣进行修复,若乳腺缺损组织量约占乳房总体积的20%~30%或切除腺体量在50~100 g之间,采用侧胸筋膜组织瓣进行修复较为合适。该术式可以满足女性患者对乳房美学效果的追求,恢复患者的自信,提高患者生活质量,在一定程度上扩大保乳指征,提高临床保乳率,侧胸皮瓣保乳整形术具有较高的临床应用价值,具有良好的安全性、有效性和美学效果,未来值得进一步推广。Domestic female breast cancer is found late,the breast defect after breast preservation is large,and the postoperative breast deformity is easy to lead to,which is a very important factor leading to the low breast preservation rate.As a kind of autologous skin flap,the lateral chest flap is a practical new flap used in breast conserving plastic surgery.Through literature research,the author summarized the clinical scenarios of the application of lateral breast flap in breast conserving plastic surgery for breast cancer,including:Lateral thoracic fascia tissue flap can be used to repair the defects in the outer upper quadrant,outer lower quadrant and central region of the breast.If the amount of breast tissue defect accounts for about 20%-30%of the total breast volume or the amount of glands removed is between 50-100 g,the lateral thoracic fascia tissue flap is more suitable for repair.The warlock can meet the female patients'pursuit of breast aesthetic effect,restore the patients'confidence,improve the patients'quality of life,expand the indications of breast preservation to a certain extent,and improve the clinical breast preservation rate.The breast conserving plastic surgery with lateral chest flap has high clinical application value,with good safety,effectiveness and aesthetic effects,and is worth further promotion in the future.

关 键 词：乳腺癌 侧胸皮瓣 保乳整形术 穿支皮瓣 临床应用 

分 类 号：R737.9[医药卫生—肿瘤]