带蒂背阔肌皮瓣在乳房重建手术中的应用

发布时间：2018-03-12 23:11

本文选题：背阔肌皮瓣　切入点：乳房重建　出处：《中国癌症杂志》2017年08期 　论文类型：期刊论文

【摘要】：随着乳腺癌治疗模式的发展及患者观念的转变,乳房重建逐渐成为乳腺癌治疗的一部分。背阔肌因面积较大,且蒂部解剖变异较少,同时血供丰富可被改良成不同的皮瓣,因此被认为是良好的供瓣区。在乳房重建中,背阔肌肌皮瓣的应用较广,不仅可以使用全背阔肌或联合假体进行乳房重建,且可以根据不同的缺损范围选择合适的背阔肌皮瓣进行乳房缺损的修补。相比单纯植入物重建,背阔肌皮瓣可获得更为良好的乳房形态且对术后放疗影响较小;相比下腹部皮瓣,背阔肌皮瓣瘢痕较短,术后恢复较快。目前对于术后供区缝合方式的改进及辅助药物的应用,极大地降低了血清肿的发生率;腔镜技术的应用也避免了切取背阔肌皮瓣遗留的供区瘢痕。在临床应用中,背阔肌皮瓣行乳房重建患者满意率高,术后审美效果良好,是乳房重建中一种较为优势的手术方法。该研究总结了背阔肌皮瓣行乳房重建对并发症的控制并对近年来的手术中的问题作进一步探讨。
[Abstract]:With the development of breast cancer treatment mode and the change of patients' concept, breast reconstruction has gradually become a part of breast cancer treatment. Latissimus dorsi has a larger area and less anatomic variation of pedicle, and the abundant blood supply can be modified into different flaps. The latissimus dorsi myocutaneous flap is widely used in breast reconstruction, and not only the total latissimus dorsi muscle or combined prosthesis can be used for breast reconstruction. The latissimus dorsi myocutaneous flap can be used to repair the breast defect according to the different defects. Compared with the simple implant reconstruction, the latissimus dorsi flap can obtain better breast shape and has less effect on postoperative radiotherapy. Compared with lower abdominal flap, latissimus dorsi flap has shorter scar and faster recovery after operation. The application of endoscopic technique also avoided the scar of donor area left by latissimus dorsi flap. In clinical application, the satisfaction rate of patients with latissimus dorsi flap for breast reconstruction was high, and the aesthetic effect after operation was good. This study summarized the control of complications in breast reconstruction with latissimus dorsi flap and discussed the problems in recent years.
【作者单位】：南京医科大学第一附属医院整形烧伤科;
【分类号】：R737.9

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