中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (36): 5899-5904.doi: 10.3969/j.issn.2095-4344.2014.36.028

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    

乳腺癌改良根治术后即刻背阔肌肌皮瓣移植重建乳房：42例分析

张敏敏，莫军扬，覃舒婷   

  1. 柳州市人民医院乳腺外科，广西壮族自治区柳州市  545006
  • 修回日期:2014-06-02 出版日期:2014-08-30 发布日期:2014-08-30
  • 通讯作者: 张敏敏，柳州市人民医院乳腺外科，广西壮族自治区柳州市 545006
  • 作者简介:张敏敏，女，1983年生，湖南省永州市人，汉族，广西医科大学在读博士，主治医师，主要从事乳腺肿瘤、乳腺整形研究。
  • 基金资助:

    广西卫生厅科技攻关项目(Z2007305)

Immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation in 42 cases

Zhang Min-min, Mo Jun-yang, Qin Shu-ting   

  1. Department of Breast Surgery, Liuzhou People’s Hospital, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China
  • Revised:2014-06-02 Online:2014-08-30 Published:2014-08-30
  • Contact: Zhang Min-min, Department of Breast Surgery, Liuzhou People’s Hospital, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China
  • About author:Zhang Min-min, Studying for doctorate, Attending physician, Department of Breast Surgery, Liuzhou People’s Hospital, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    Science and Technology Project of Health Bureau of Guangxi Zhuang Autonomous Region, No. Z2007305

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摘要：

背景：在根治肿瘤的同时如何保持女性乳房的形态完美这一问题得到了越来越多医生及患者的关注，乳房再造由此而产生、发展，逐渐成为乳腺癌治疗的重要组成部分。
目的：探讨乳腺癌改良根治术后即刻背阔肌肌皮瓣移植重建乳房的可行性及疗效。
方法：纳入42例女性单侧乳腺癌患者，均进行保留乳头乳晕或保留乳房的改良根治术，术后即刻自体背阔肌皮瓣或扩大背阔肌肌皮瓣移植重建乳房，根据客观标准及主观标准评价重建效果。
结果与结论：42例中，33例行保留乳头乳晕的乳腺癌改良根治术、9例行保留皮肤的乳腺癌改良根治术，背阔肌乳房重建24例、扩大背阔肌乳房重建18例。转移皮瓣及重建的乳房全部成活，无严重并发症发生。客观评价美容效果优良39例，一般3例；主观评价优良者40例，尚可者2例。随访9-41个月，所有患者无肿瘤局部复发，1例出现骨转移。表明乳腺癌改良根治术后即刻采用背阔肌移植重建乳房操作简单、易行，整形效果好，安全性高，成活率高。


中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程


全文链接：

关键词: 移植, 组织构建, 背阔肌皮瓣, 修复重建, 即刻乳腺重建, 乳腺癌改良根治术

Abstract:

BACKGROUND: How to keep the intact shape of the breast while treating tumor has been widely concerned by more doctors and patients, breast reconstruction is introduced, developed and considered an important part in the treatment of breast tumors.
OBJECTIVE: To explore the feasibility and therapeutic effects of immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation.
METHODS: We retrospectively analyzed the clinical and pathological features of 42 breast cancer patients under immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap or extended latissimus dorsi musculocuraneous flap. The procedure duration, postoperative complications and cosmetic outcome were assessed.
RESULTS AND CONCLUSION: Among the involved 42 patients, 33 cases underwent modified radical mastectomy, retaining the nipple and areola of breast, 9 cases underwent modified radical mastectomy, retaining the skin of breast, 24 cases underwent breast reconstruction with latissimus dorsi musculocuraneous flap,
18 cases underwent breast reconstruction with extended latissimus dorsi musculocuraneous flap. The skin flap and reconstructed breast all survived, without severe complications. According to objective evaluation results, the cosmetic outcome was good in 39 cases and fair in 3 cases. The subjective evaluation results were good in 40 cases and fair in 2 cases. All the patients were followed up for 9-41 months. One patient had bone metastasis 19 months after operation and there was no case with local recurrence. Immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap is a simple and feasible operation process, with optimal effects, high security, and high survival.



中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程


全文链接：

Key words: breast neoplasms, mastectomy, modified radical, surgical flaps, transplantation

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