扩大背阔肌肌皮瓣在保留皮肤的乳腺癌改良根治术后一期乳房再造中的应用

目的 评价扩大背阔肌肌皮瓣在乳腺癌改良根治术后一期乳房再造中的应用价值.方法 选取2010年1月至2011年8月期间收治的100例乳腺癌患者,根据所接受的术式分为扩大背阔肌肌皮瓣一期乳房再造组（n=48）和单纯乳腺癌改良根治术组（n=52）,对两组患者术后并发症、恢复情况以及生活质量进行对比,并对再造乳房外观形态进行评价.结果 乳房再造组患者均成功行扩大背阔肌肌皮瓣乳房再造,再造乳房外形明显优于单纯根治组（P〈0.05）.两组患者住院时间、引流时间及开始辅助治疗时间差异无显著性（P〉0.05）,但乳房再造组术后生活质量较好,与单纯根治组比较差异有统计学意义（P〈0.05）.两组患者随访期间未见局部复发及转移.结论 乳腺癌根治术后扩大背阔肌肌皮瓣一期再造乳房形态效果良好,手术操作简单,是一种安全可行的治疗方法.

Study on application of extended dorsi-latissimus flap in immediate breast reconstruction after skin-sparing mastectomy.

Objective To evaluate the value of application of extended dorsi latissimus flap （ELDF） for immediate breast reconstruction in patients with breast cancer after modified radical mastectomy. Methods Fifty two patients with breast cancer accepted modified radical mastec tomy and 48 patients with breast cancer accepted immediate breast reconstruction after modified radical mastectomy during January 2010 to August 2011 were included in this study. Complications, cosmetic result and quality of life in these patients were compared and evaluated. The shape of breast reconstruction was also evaluated. Results All of 48 patients succeeded in proceeding immediate breast reconstruction with ELDF. The e valuation of shape of breast reconstruction was better than that of patients with radical operation group （ P 〈 0.05 ）. There was no statistical differ ence in duration of drainage, hospitalization stay, and starting time for adjuvant therapy between these two groups （ P 〉 0.05 ）. Patients in breast reconstruction group had a better quality of life （ P 〈 0.05 ）. During follow up period, no local recurrence and metastasis had been demonstrated in patients of these two groups. Conclusion There is good cosmetic result after immediate breast reconstruction with ELDF, and it is easy to be operated. It is a safe and feasible therapeutic procedure for treatment of patients with early breast cancer.