乳腺癌术后即刻采用对侧血管蒂DIEP皮瓣乳房重建

Immediate breast reconstruction with contralateral DIEP flap following breast cancer surgery

目的 探讨乳腺癌术后利用对侧(健侧)腹壁下动脉穿支(deep inferior epigastric perforator flap, DIEP)血管蒂皮瓣即刻行乳房重建的临床应用效果。方法 回顾性分析自2022年1月至2023年12月,中日友好医院整形外科收治的10例乳腺癌改良根治术后即刻行DIEP皮瓣乳房重建的患者资料。患者年龄34~61岁(平均44.6岁);体质量指数(BMI)21.2~30.4 kg/m^(2),2例伴有下腹部手术史(1例横行剖宫产切口,1例腹部手术纵行切口),术前化疗1例。10例患者均采用了对侧(健侧)单血管蒂DIEP皮瓣。结果 10例患者DIEP皮瓣乳房重建术术后皮瓣成活率为100%,重建乳房均外形良好,触感柔软,无严重并发症发生,患者满意率为90.0%(9/10)。结论 乳腺癌术后即刻采用对侧(健侧)DIEP血管蒂皮瓣重建乳房术后效果良好,快速设计皮瓣、两组术者分工合作可以缩短手术时间,优化手术进程,有利于DIEP皮瓣重建乳房技术的推广普及。

Objective To investigate the clinical effect of immediate breast reconstruction with contralateral(healthy side)DIEP vascular pedicle flap following breast cancer surgery.Methods The data of 10 patients who underwent immediate breast reconstruction with DIEP flap after modified radical mastectomy in China-Japan Friendship Hospital from January 2022 to December 2023 were retrospectively analyzed.Patients ranged in age from 34 to 61 years(mean 44.6 years);BMI 21.2 to 30.4 kg/m^(2),2 patients had a history of lower abdominal surgery(1 case with transverse cesarean incision,1 case with longitudinal abdominal incision),and 1 case with preoperative chemotherapy.All the patients received a contralateral(healthy side)single-vessel pedicled DIEP flap.Results The survival rate of 10 cases after DIEP flap breast reconstruction was 100%.All the reconstructed breasts were good in appearance,soft in touch and without serious complications.The patient satisfaction rate was 90.0%(9/10).Conclusion Immediate breast reconstruction with contralateral(healthy side)DIEP vascular pedicle flap is effective after breast cancer surgery.Rapid design of the flap and the division of labor between the two groups can shorten the operation time and optimize the operation process,which is conducive to the popularization of DIEP flap reconstruction technology.