评价游离真皮脂肪瓣在保留乳房手术中应用的可行性及疗效。

回顾性分析柳州市人民医院2016年7月至2019年12月期间收治的39例接受游离真皮脂肪瓣辅助乳腺癌保留乳房术患者的临床资料和随访结果，并对该术式的术后并发症、乳房外形进行评估。

39例患者游离真皮脂肪瓣质量中位数98 g(范围：76～135 g)，切除乳腺组织质量中位数81 g(范围：60～114 g)，中位手术时间245 min(范围：215～305 min)，39例真皮脂肪瓣均存活。术后并发症发生率为12.8%(5/39)，分别为2例脂肪液化、1例脂肪液化合并切口坏死感染、1例血肿、1例腹壁供区切口愈合不良。39例患者中，术后外形客观评价为优良者35例(89.7%)，主观评价为优良者36例(92.3%)。所有患者随访2～43个月，中位随访时间24个月，出现局部复发1例，远处转移5例，无死亡病例。

游离真皮脂肪瓣应用于保留乳房手术是可行的，对于提高保留乳房手术率、保证术后乳房外形有积极意义。

To evaluate the feasibility and efficacy of free dermal fat graft (FDFG) in breast conserving surgery (BCS).

A retrospective analysis was performed on the clinicopathological data and follow-up results of 39 patients who underwent FDFG-assisted BCS in the Liuzhou People’s Hospital from July 2016 to December 2019. Postoperative complications and appearance of the breast were evaluated.

The median weight of FDFG in 39 patients was 98 g (76-135 g), the median weight of removed breast tissue was 81 g (60-114 g) and the median operative time was 245 min (215-305 g). All the FDFG survived. The incidence of postoperative complications was 12.8% (5/39), including 2 cases of fat liquefaction, 1 case of fat liquefaction combined with incision necrosis and infection, 1 case of hematoma and 1 case of poor incision healing at the abdominal wall donor site. The objective and subjective evaluation of postoperative breast appearance was excellent in 35 cases (89.7%) and 36 cases (92.3%), respectively. All patients were followed up for 2 to 43 months, median 24 months. One patient had local recurrence, 5 patients had distant metastasis and no death occurred.

The application of FDFG in BCS is feasible, with potentials in increasing the breast-conserving rate and improving cosmetic outcome.