乳腺癌改良根治术后同时应用腹壁下动脉穿支皮瓣游离移植再造乳房

Immediate breast reconstruction with DIEP flap following modified radical mastectomy

目的介绍乳腺癌改良根治术后即刻应用腹壁下动脉穿支(DIEP)皮瓣游离移植行乳房再造的方法与疗效。方法2003年6月至2005年6月,对6例Ⅰ期乳腺癌、2例Ⅱ期乳腺癌患者行改良根治术,即刻应用DIEP皮瓣Ⅰ期再造乳房。结果全部皮瓣均成活,2例有轻微并发症,1例部分皮瓣淤血坏死,1例出现皮瓣下积血。均随访半年以上,未见肿瘤复发和转移,未见腹壁疝和腹壁膨出发生。再造乳房患者自评分7·75±0·88。结论乳腺癌术后Ⅰ期选用DIEP皮瓣游离移植再造乳房,是乳腺癌改良根治术后恢复乳房外形的一种理想方法。

Objective To review the experience in immediate breast reconstruction with DIEP flap following modified radical mastectomy. Methods From 2003 to 2005, eight patients with breast cancer have undergone modified radical mastectomy and immediate breast reconstruction with deep inferior epigastric perforator flap. Six patients had stage Ⅰdisease and 2 patients had stage Ⅱ disease. Results The flaps in all the cases survivedo Two occured minor complications. A small part of venous congestion occurred in one flap. One patient had hematoma under the flap. Follow up more than 6 months, no evidence of recurrence and metastasis occurs. Postoperative abdominal wall examination didn＇t reveal and hernia and bulging. Patient satisfaction with the reconstructed breast was rated high. The reconstructed breast achieved good results in shape, colour and symmetry. Conclusion The procedure introduced is an ideal method for breast reconstruction after modified radical mastectomy.