乳腺癌切除术后腹壁下动脉穿支皮瓣乳房重建疗效观察

Observation on the therapeutic effects of breast reconstruction using deep inferior epigastric perforator flap after resection of breast cancer

目的 采用保留乳头乳晕的乳腺病灶切除术后,即刻腹壁下动脉穿支（DIEP）皮瓣乳房重建,探讨乳腺癌术后DIEP即刻乳房重建的近期疗效。方法 对我院2011年1月至2015年1月期间接受DIEP乳房再造的14例乳腺癌患者进行回顾性分析,探讨该术式的特点及临床适应证,并对其美容效果及术后并发症进行评估。术后随访1-24个月。结果 14例患者乳房重建均获成功,所有皮瓣全部成活,2例出现皮瓣远端坏死,胸部受区出现1例血肿。术后随访1-24个月,重建乳房外形满意,供区无腹壁疝、腹壁膨出、腹壁薄弱等并发症发生。结论 使用DIEP重建乳房是安全可靠的,切口隐蔽,同时具有受区组织条件好、皮瓣组织量丰富、供区损伤小及并发症少的优点,能同时满足肿瘤治疗及形体美观的要求。

Objective To evaluate the early outcomes of breast reconstruction with immediate deep inferior epigastric perforator（ DIEP） flaps after resection of breast cancer with DIEP reconstruction after modified radical mastectomy with papilla and mammary areola reserving. Methods A retrospective analysis of 14 breast cancer patients who were hospitalized and received breast reconstruction from January 2011 to January 2015 was made,so as to investigate the features of the surgery and its clinical indications. Then,evaluations were performed on the cosmetic effects and postsurgical complications. A 1-24-month medical follow-up was made after surgery. Results Breast reconstruction surgery was successful in all the 16 patients,all the flaps completely survived postoperatively,with 2 cases of distal skin flap necrosis and 1 case of hematoma in the surgical site. No complications such as abdominal hernia or bulge in donor sites were found and the reconstructed breast was well-shaped. Conclusion The immediate DIEP reconstruction is safe and reliable,at the same time,it has the advantages of hidden incision,rich blood supply of the affected area,abundant tissue volume,minimal donor site damage,less complications,which met the requirements of oncotherapy and aesthetics as well.