背阔肌皮瓣联合假体即刻乳房重建术的应用

摘要

Objective To introduce the clinical experience of immediate breast reconstruction with the latissimus dorsi flap combined with implants following mastectomy in patients with breast cancer.Methods Twenty-six patients with early breast cancer in our department who underwent immediate breast reconstruction with the latissimus domi flap combined with implants following mastectomy were included in the study.The operative technical details,postoperative complications and patient satisfaction were analyzed retrospectively.Results Donor site seroma occurred in 6 patients(23.1％),which disappeared after repeated aspiration and pressure dressing.Capsular contracture occurred in 1 patient (3.85 ％),which was improved by reoperation.There was no flap necrosis and no wound infection.Follow-up period ranged from 3 to 44 months (average 32.3 ± 7.02).Cosmetic outcome was judged excellent and good in 84.6 ％.Conclusion In selected patients with breast cancer,the latissimus dorsi flap combined with implants is a reliable method with less complication and good operation effect for immediate breast reconstruction.%目的 总结背阔肌皮瓣联合假体即刻乳房重建术的临床经验.方法 回顾性分析26例早期乳腺癌患者接受改良根治同期背阔肌皮瓣转移联合假体乳房重建术的临床资料,总结手术技巧、术后主要并发症,评价术后满意度.结果 手术后背部伤口血清肿6例(占23.1％),均经穿刺抽液及加压包扎后治愈；假体包膜挛缩1例(占3.85％),再次行包膜松解术后好转；无皮瓣坏死,无伤口感染.随访3～44个月,平均(32.3±7.02)个月.全部病例无局部复发及远处转移,无上肢活动明显受限及上肢水肿或功能障碍.再造乳房按美学评分:优秀13例,良好11例,尚可2例,差0例.患者满意率84.6％.结论 对于选择性的早期乳腺癌患者,背阔肌皮瓣联合假体即刻乳房重建术是一种并发症少、手术效果良好的乳房重建方法.