胸廓内血管及其肋间穿支作为受区血管在游离皮瓣移植乳房再造中的临床应用

目的:研究胸廓内血管及其肋间穿支用作游离皮瓣乳房再造的受区血管的可能性及其应用。方法:新鲜成人女性尸体2具,自胸廓内动静脉起始处灌注乳胶颜料,观察胸廓内血管及其肋间穿支的基本走形、穿出点位置等。选择10例适合游离皮瓣乳房再造的乳腺癌患者开展胸廓内血管及其肋间穿支作为受区血管的临床手术研究,对患者的效果进行评估。结果:胸廓内血管走形稳定、血管直径较为理想,1~4肋间穿支直径达1mm以上,第3、4穿支较为粗大。10例乳房再造患者,随访6个月~1年,术后效果好,无严重并发症,无明显功能障碍,患者满意度高。结论:胸廓内血管及其肋间穿支是良好的游离皮瓣移植乳房再造的受区血管,解剖容易,不损伤重要组织,术后效果良好,值得进一步推广。

Application of internal thoracic plus intercostal vessels as recipient vessels in free flap breast reconstruction

Objective To study the application of internal thoracic plus intercostal vessels as recipient vessels in free flap breast reconstruction. Methods 2 fresh female adult cadavers were used. They were infused by red latex.Distribution and anastomosis of the internal thoracic artery and veins along with intercostal vessels were observed.In addition,ten breast cancer patients with negative sentinel lymph node biopsy underwent mastectomy with free flap breast reconstruction using internal thoracic plus intercostal vessels as recipient vessels in free flap breast reconstruction in our department. Cosmetic outcome were assessed. Results Locations of internal thoracic vessels were steady. Vessels＂ diameter was ideal for anastomosis.The first to the fourth intercostal perforating vessels＂ diameter were more than 1 mm. Among them, the third and the fourth intercostal perforating vessels were coarser.For these 10 breast reconstruction patients, they were followed up for six months to one year after the surgery. All the patients were satisfied with good results. No serious complications and dysfunctions were found. Conclusion Internal thoracic plus intercostal vessels can be used as recipient vessels in free flap breast reconstruction. Postoperative effect was good. Furthermore, dissection of internal thoracic plus intercostal vessels was too easy to damage other important organs.Consequently,application of internal thoracic plus intercostal vessels as recipient vessels in free flap breast reconstruction deserves further promotion.