部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣在外侧象限乳腺癌保乳治疗中的应用

发布时间：2019-03-17 18:38

【摘要】：目的总结在外侧象限乳腺癌保乳术后采用部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣重建乳房的效果。方法 2012年9月—2016年9月,收治18例外侧象限乳腺癌女性患者。年龄41~65岁,平均46.5岁。浸润性导管癌17例,黏液腺癌1例。均为单发肿物,直径2.5~4.0 cm,距离乳头乳晕3~5 cm。患者乳房体积均为中-小型。保乳术后应用部分背阔肌皮瓣(13例)或侧胸壁脂肪筋膜皮瓣(5例)重建乳房。术后均行放疗。结果术后1例出现部分侧胸壁脂肪筋膜皮瓣坏死合并感染,其余皮瓣均顺利成活。16例切口Ⅰ期愈合,2例出现血清肿,穿刺抽液及加压包扎后Ⅱ期愈合。术后患者均获随访,随访时间6~50个月,平均26.8个月。术后6个月参照Kim等标准评价乳房重建效果,优12例、良4例、一般2例。随访期间未出现局部复发及远处转移。结论外侧象限乳腺癌保乳术后应用侧胸壁手术切口联合部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣重建乳房,可以获得满意的美容效果。
[Abstract]:Objective to summarize the effect of partial latissimus dorsi flap or fat fascia flap on breast reconstruction after breast preservation in lateral quadrant breast cancer. Methods from September 2012 to September 2016, 18 female patients with lateral quadrant breast cancer were treated. The average age was 46.5 years (41 / 65). There were 17 cases of invasive ductal carcinoma and 1 case of mucinous adenocarcinoma. All of them were solitary, 2.5 to 4.0 cm, in diameter, 3 to 5 cm. in diameter from nipple areola. The breast volumes of the patients were medium to small. Breast reconstruction was performed with partial latissimus dorsi myocutaneous flap (13 cases) or lateral chest wall fat fascia flap (5 cases). All patients were treated with radiotherapy. Results Fat fascia flap necrosis and infection occurred in 1 case, the remaining flaps survived successfully, 16 cases healed first stage, 2 cases showed seroma, puncture fluid extraction and compression bandaging healed in the second stage. All patients were followed up for 6 months and 50 months (mean 26.8 months). At 6 months after operation, 12 cases were excellent, 4 cases were good and 2 cases were normal. According to Kim criteria, the results of breast reconstruction were excellent in 12 cases and good in 4 cases. There was no local recurrence or distant metastasis during the follow-up period. Conclusion the surgical incision of lateral chest wall combined with partial latissimus dorsi flap or fat fascia flap of lateral chest wall can be used to reconstruct breast after breast preservation in lateral quadrant breast cancer, and satisfactory cosmetic effect can be obtained.
【作者单位】：广州医科大学附属第二医院乳腺外科;
【分类号】：R737.9

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