背阔肌肌皮瓣在保乳术和乳房再造术中的临床应用研究

目的探讨背阔肌肌皮瓣在保乳术和乳房再造中的应用价值。方法2006年1月～2008年8月，我们利用背阔肌肌皮瓣对23例年龄为31～55岁（平均36岁）的乳腺肿瘤患者进行乳房的修复与再造（其中良性肿瘤3例，叶状囊肉瘤1例，乳头paget＇s病2例，乳腺癌17例）。分别采用乳腺局部扩大切除（保乳术）后即刻部分背阔肌转移修补缺损（部分乳房再造），保留皮肤改良根治术后或保留乳头乳晕改良根治术后即刻扩大背阔肌肌皮瓣（E—LDMF）乳房再造和延期背阔肌乳房再造。其中3例我们利用腔镜辅助下经腋下小“S”形切口进行背阔肌肌瓣切取，缩小了供区切口长度．减轻了，创伤一对手术时间，术后并发症和美学效果进行评估。结果平均手术时间210min，再造乳房全部成活，无严重的并发症发生一美容效果优5例、良好15例、尚可3例、无外形差的病例。术后患者对乳房形态均满意。结论背阔肌肌皮瓣乳房再造操作简便，应用广泛，术后并发症小，再造乳房形态良好，是一种理想的乳房再造方法。

Clinical application of latissimus dorsi myocutaneous flap in breast--conserving surgery and breast recontruction.

Objective To evaluate the clinical application of latissimus dorsi myocutaneous flap in breast reconstruction. Methods From January 2006 to August 2008,23 women aged 31-55 years（median 36 years） underwent breast reconstruction with latissimus dorsi myocutaneous flap after breast-conserving surgery,skin-sparing mastecto- my and nipple-sparing mastectomy.The procedure duration, postoperative complications and cosmetic outcome were assessed. Results The mean procedure duration was 210min. There was no flap necrosis and no sever complication. The cosmetic outcome was excellent in five, good in fifteen,fair in three,and no poor effect of the patients. A satisfacto- ry cosmetic result was achieved in all patients. Conclusion Latissimus dorsi myocutaneous flap application is a optimal method for breast reconstruction with low risk,The procedure is easily performed and with good cosmetic outcome.