目的

探讨如何选择乳腺癌手术后乳房重建的手术方法及效果分析。

方法

根据患者乳腺癌手术的具体方法及个体差异，选择转移下腹部横行腹直肌肌皮瓣、背阔肌肌皮瓣、腹壁下动脉穿支游离皮瓣或联合假体乳房重建158 例。

结果

转移下腹部横行腹直肌肌皮瓣乳房重建93 例，其中即刻乳房重建65 例（满意率为95.38% ） ，延期乳房重建28 例（满意率为92.86% ）。 背阔肌肌皮瓣或联合假体乳房重建59 例，满意率为96.61% 。 腹壁下动脉穿支游离皮瓣乳房重建3 例，满意率为100% 。 假体植入乳房重建3 例，满意率为100% 。

结论

乳腺癌手术后选择适当乳房重建的手术方法十分重要；根据个体差异选择不同乳房重建术式，使重建的乳房更加逼真，达到令人满意的效果。

Objective

To study the methods of breast reconstruction after mastectomy for breast cancer patients.

Methods

158 cases underwent breast reconstruction， either with TRAM flap or with latissimus dorsi flap with/without implants， according to breast śize， shape， local treatment of breast cancer and desire of the patient.

Results

All patients were followed up from 1 to 74 months.In the TRAM flap group，the satisfaction rate was 95.38% for immediate breast reconstruction （65 cases） and 92.86% for delayed breast reconstruction （28 cases）.In the latissimus dorsi flap with/without implant group （59 cases）， the satisfaction rate is 96.61% .

Conclusions

It is important to choose an appropriate method for breast reconstruction， which could make the reconstructed breast symmetry to normal breast and improve the quality of life.