摘要
乳腺癌根治性切除术后的自体乳房重建目前已被广泛应用于临床,但某些术式的自体乳房重建手术会造成一定程度的腹壁缺损。腹壁缺损导致腹壁正常功能的缺失,进而引起一系列严重的病理生理学改变。目前常用的手术方式有带蒂腹直肌皮瓣和腹壁下深动脉穿支皮瓣的乳房重建。根据乳腺癌术后乳房自体重建术后不同的腹壁缺损的类型,应该在严格遵循腹壁修复的基本原则的基础上,制定相应的手术修补方案。同时根据不同的腹壁缺损范围选择适当的腹壁修复材料。乳房重建术后形成的腹壁缺损通常其腹直肌后鞘和腹膜是完整的,腹直肌前鞘也可能保留,手术方式可选择腹壁不同层次的修复,同时强调应用修补材料进行修复。
Autologous breast reconstruction after radical resection of breast cancer has been widely used in clinic.Some surgical methods of autologous breast reconstruction may cause abdominal wall defect to a certain extent.The abdominal wall defect leads to the loss of normal function,which leads to a series of serious pathophysiological changes.At present,transverse rectus abdominis myocutaneous flap(TRAM)and deep inferior epigastric artery perforator flap(DIEP)are commonly used for breast reconstruction.According to the different types of abdominal wall defect after breast autoreconstruction for breast cancer surgery,the corresponding surgical repair scheme should be formulated on the basis of strictly following the basic principles of abdominal wall repair.At the same time,appropriate materials for repairing abdominal wall defect are selected according to the different extent of abdominal wall defect.The posterior sheath and peritoneum of rectus abdominis are usually intact after breast reconstruction,and the anterior sheath of rectus abdominis may be retained.The different layers of abdominal wall can be repaired by surgical methods,and the application of repair materials is emphasized.
作者
唐健雄
李蔚萍
TANG Jian-xiong;LI Wei-ping(Department of General Surgery,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)
出处
《中国实用外科杂志》
CSCD
北大核心
2019年第11期1172-1175,共4页
Chinese Journal of Practical Surgery
关键词
乳腺癌
乳房切除术
乳房重建
腹壁缺损
修补材料
breast cancer
mastectomy
breast reconstruction
abdominal wall defect
repair material