目的

探讨乳腺癌保留乳房手术中利用胸外侧筋膜皮瓣填充组织缺损的效果和可行性。

方法

在乳腺癌保留乳房手术中,先行肿瘤扩大切除术,切缘距离瘤缘至少0.5 cm,同时切除肿瘤表面受侵的皮肤,设计三角形胸外侧筋膜皮瓣用以填充组织缺损,并利用此皮瓣切口完成腋窝淋巴结切除。

结果

共完成7例,切除肿瘤的最大直径为5.5 cm,切缘均无癌残留,有3例切除乳头、乳晕复合体。平均手术时间3 h,平均出血量300 ml。术后未发生皮瓣坏死等并发症。术后平均随访19.5个月,均未出现复发,美容效果均为优良,患者对乳房外形的自我感觉均为满意。

结论

在乳腺癌保留乳房手术中,利用胸外侧筋膜皮瓣填充组织缺损的效果满意,可以使一部分失去保留乳房手术机会的妇女接受保留乳房手术治疗。

Objective

To investigate effectiveness and feasibility of breast defects reparation with lateral thoracodorsal fasciocutaneous flap following breast conserving surgery.

Methods

In our study of breast conserving surgery,all the patients were treated by extended tumor resection.The surgical margin was at least 0.5 cm,and the skin that invaded by the tumor was resected together.Then a triangular lateral thoracodorsal fasciocutaneous flap was designed to fill the skin defect,and the incision was used to complete the axillary lymph node dissection.

Results

A total of 7 patients received this surgery.The biggest diameter of the tumors resected was 5.5 cm and the surgical margin showed no cancer cells residue,three patients had their nipple-areola complex removed.The average operative time was 3 hours,the average bleeding amount was 300 ml.No postoperative complications such as skin flap necrosis occurred.The median postoperative follow-up time was 19.5 months,and no relapse was found in all the patients.The esthetic results were excellent,and all the patients were satisfied with their breast appearance.

Conclusions

It's a good method to use lateral thoracodorsal fasciocutaneous flap to fill breast tissue defects following breast conserving surgery,and this method may give more chances to the women of breast cancer who have lost the opportunity of breast conserving surgery.