乳腺癌保乳术中胸外侧筋膜皮瓣在乳房缺损修复中的应用

The Application of the Lateral Thoracic Fascial Flap in Breast Conserving Surgery for Breast Reconstruction

目的探讨胸外侧筋膜皮瓣在乳腺癌保乳术中修复乳房缺损的应用效果。方法回顾分析行乳腺癌保乳术的73例乳腺癌患者的临床资料,根据乳房修复方法进行分组,其中对照组35例采用背阔肌肌皮瓣移植,观察组38例采用胸外侧筋膜皮瓣移植,观察2组患者术中出血量、手术时间、术后乳房重建效果、复发率及并发症发生情况,并对患者满意度进行调查评估。结果所有患者均成功完成手术,且术后均无肿瘤复发。2组患者手术时间、术中出血量比较,差异有统计学意义(P<0.05);2组患者术后乳房外观比较差异无统计学意义(P>0.05);患者对手术满意度评价,差异无统计学意义(P>0.05);观察组术后并发症发生率低于对照组,组间差异有统计学意义(P<0.05)。结论在乳腺癌病灶切除术中,利用胸外侧筋膜皮瓣填充乳房缺损部位能够明显缩短手术时间,降低术后并发症的发生率。

Objective To investigate the application of lateral thoracic fascial flap in breast reconstruction following breast conserving surgery. Methods The clinical data of 73 patients with breast cancer who underwent breast conserving surgery were retrospectively analyzed, and all the patients were grouped according to the breast repair method, among them, 35 patients in the control group were transplanted with latissimus dorsi myocutaneous flap and 38 patients in the observation group were trans- planted with lateral fascia flap. The intraoperative blood loss, operative time, postoperative breast reconstruction, recurrence rate and complications were observed in the 2 groups, and the satisfaction of the patients was investigated and evaluated. Results All patients were successfully completed the surgery, and there was no tumor recurrence after operation. The operative time and intrao- perative blood loss were significantly different between the 2 groups （ P 〈 0.05 ） , hut the postoperative breast appearance aud satis- faction of patients in the 2 groups had no significant difference（ P 〉0.05 ）. The incidence of postoperative complications was sig- nificantly lower in the observation group than in the control group （ P 〈 0.05 ）. Conclusion In patients with breast cancer resec- tion, the use of lateral thoracic fascial flap to fill the defect site can significantly shorten the operation time and reduce the inci- dence of postoperative complications.