Randolph Laura C, Barone Julie, Angelats Juan, Dado Diane V, Vandevender Darl K, Shoup Margo
Division of Plastic and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL 60143, USA.
Plast Reconstr Surg. 2005 Oct;116(5):1287-90. doi: 10.1097/01.prs.0000181517.20122.36.
The latissimus dorsi flap has become a first-line option in reconstruction of the breast cancer patient. Donor-site seroma is a commonly described postoperative complication of the latissimus dorsi flap.
A retrospective chart review from 1998 to 2003 of all patients undergoing latissimus dorsi breast reconstruction was performed (n = 50). Age of the patients, timing of breast reconstruction, type of nodal dissection (axillary versus sentinel versus none), and chemotherapy status of the patients were examined.
The overall incidence of seroma formation was 47 percent. Those patients who had undergone prior or concurrent nodal dissection at the time of breast reconstruction were found to have a higher incidence of seroma formation than patients who had no nodal dissection (52 percent versus 25 percent) (p = 0.15). Age also was a risk factor for seroma formation, as 63 percent of patients older than 50 had formed seroma as compared with 39 percent of those younger than age 50 (p = 0.08).
The authors conclude that advanced age and the presence of nodal disruption before or concurrent with latissimus dorsi breast reconstruction are predictors of donor-site seroma formation.
背阔肌肌皮瓣已成为乳腺癌患者乳房重建的一线选择。供区血清肿是背阔肌肌皮瓣术后常见的并发症。
对1998年至2003年期间所有接受背阔肌乳房重建的患者进行回顾性病历审查（n = 50）。检查患者的年龄、乳房重建时间、淋巴结清扫类型（腋窝清扫、前哨淋巴结活检或未进行淋巴结清扫）以及患者的化疗情况。
血清肿形成的总体发生率为47%。发现那些在乳房重建时曾接受过先前或同期淋巴结清扫的患者血清肿形成的发生率高于未进行淋巴结清扫的患者（52%对25%）（p = 0.15）。年龄也是血清肿形成的一个危险因素，50岁以上患者中有63%形成了血清肿，而50岁以下患者中这一比例为39%（p = 0.08）。
作者得出结论，高龄以及在背阔肌乳房重建之前或同期存在淋巴结破坏是供区血清肿形成的预测因素。
