局部皮瓣在乳腺癌保乳术后一期修复中的应用

目的 观察应用局部皮瓣修复保乳术后乳房缺损的临床疗效。方法 2004年7月至2013年1月,对9例早期乳腺癌患者保乳手术所遗留的乳房缺损进行即刻修复,采用外侧胸背筋膜皮瓣7例,胸腹壁皮瓣2例,观察皮瓣成活情况、并发症和术后美观效果。结果 术后外观评价8例为优,1例为良。1例患者出现皮瓣局部坏死,经保守治疗愈合。1例患者出现皮瓣供区感染,口服抗菌素治疗,未影响手术效果。术后平均随访22个月,未见局部复发病例。结论 应用局部皮瓣修复保乳术后乳房部分缺损,手术效果好,并发症少,可扩大肿瘤周围的切除范围,降低肿瘤局部复发风险。

The Application of Local Flap in Immediate Reconstruction after Breast Conserving Surgery for Breast Cancer

Objective To evaluate the clinical outcomes and aesthetic results of immediate reconstruction of partial mastectomy defects by local skin flaps. Methods From July 2004 to January 2013, 9 patients with breast cancer of early stage underwent immediate reconstruction of partial mastectomy defects using lateral thoracodorsal fasciocutaneous flap (n=7) and thoracoepigastric flaps (n=2). Flap and donor site complications were evaluated. Information on aesthetic results was collected. Results The final cosmetic result was considered to be excellent in 8 patients and good in one patient. Limited flap necrosis occurred in one patient and was treated by a conservative approach. The one case of donor site infection was treated with oral antibiotics and achieved satisfactory results. Mean time of follow-up was 22 months, no local recurrences were observed. Conclusion Immediate repair of partial mastectomy defects with local skin flap results in a low risk of complications and excellent aesthetic outcomes. The technique facilitates the breast surgeon’s ability to accomplish a widely negative resection margin around tumor, which has the potential to achieve lower rates of local recurrence.