背阔肌皮瓣联合假体在乳腺癌患者Ⅰ期乳房重建中的临床应用

目的介绍背阔肌皮瓣联合假体应用于乳腺癌患者Ⅰ期乳房重建的临床经验。方法回顾性分析14例应用背阔肌皮瓣联合假体行乳腺癌术后Ⅰ期乳房重建病例的临床资料,其中患者平均年龄44.2(20~54)岁,Ⅰ期乳腺癌4例,Ⅱa期8例,Ⅱb期2例。经背部和腋部切口分别为6例和8例。结果手术后无皮瓣坏死;无伤口感染;供区血清肿5例(35.7%),均经穿刺抽液治愈。平均随访32.6(4~58)月,2例患者接受了放射治疗未发现不良后果,患者对再造乳房形态非常满意8例,满意5例,一般1例,无不满意患者,乳房美学评价按照Ueda标准均6分,优良率为100%。结论对于选择性的乳腺癌患者,乳房切除后背阔肌皮瓣联合假体Ⅰ期乳房重建是一种并发症少、手术效果良好的乳房重建方法 。

Immediate Breast Reconstruction Using the Latissimus Dorsi Flap Combined with Implants for Breast Cancer

Objective To evaluate the results of immediate breast reconstruction with the latissimus dorsi flap combined with implants in patients with breast cancer following mastectomy.Methods The clinical data of the patients who had undergone immediate breast reconstruction with the latissimus dorsi flap combined with implants following mastectomy dating from February 2005 to August 2009 were collected.The operative technical detail,postoperative complications,esthetical results and patient satisfactions were analyzed.Results Fourteen patients with breast cancer underwent immediate breast reconstruction with the latissmus dorsi flap combined with implants following mastectomy,including stage Ⅰ,Ⅱa,Ⅱb in 4,8 and 2 patients respectively.The mean age was 44.2 years（range,20~54 years）.The length of follow-up ranged from 4 to 58 months.There was no flap loss.Donor site seroma occurred in 5 patients（35.7%）,which disappeared after repeated aspiration.Wound infection was not observed.Eight patients were very satisfied with the reconstructive breast,5 satisfied,one considered the result to be fair.All of the patients were satisfied with the breast shape.Cosmetic outcome was judged as excellent or good in 100%.Conclusion In selected patients with breast cancer the latissimus dorsi flap combined with implants is a relatively easy and reliable method for immediate breast reconstruction.