Delaporte T, Sinna R, Perol D, Garson S, Vasseur C, Delay E
Unité de Chirurgie Plastique et Reconstructrice, Département de Chirurgie, centre Léon-Bérard, 28, rue Laënnec, 69373 Lyon cedex 08, France.
Ann Chir Plast Esthet. 2006 Dec;51(6):482-93. doi: 10.1016/j.anplas.2006.02.001. Epub 2006 Apr 21.
The purpose of this study was to analyse the advantages, disadvantages and results of bilateral breast reconstruction by autologous latissimus dorsi flap.
Thirty-one two-stage consecutive bilateral breast reconstructions were performed by the same operator between 1993 and 2001. All the reconstructions, in immediate or delayed manner, were indicated after radical or skin sparing mastectomy for breast cancer. We used the autologous latissimus dorsi flap for all cases. The reconstruction of the second breast was always delayed of a few months to avoid back's complications. We reviewed the charts of these patients retrospectively. Preoperative data, postoperative complications, dorsal seroma occurrence, morphological results and patient's satisfaction were evaluated. Median follow-up was 22 months.
The results confirm the procedure's reliability. Comparative rates of postoperative complications are not significantly different between first and contralateral breast reconstruction. Functional after-effects of bilateral latissimus dorsi harvesting are moderate. The aesthetics results have been judged as very good in 84% of cases and good in 16%. The satisfaction rate of the patients is high: 90,3% are pleased, 6,5% are satisfied and 3,2% are moderately satisfied.
The autologous latissimus dorsi flap allows a two-stage bilateral breast reconstruction. This procedure is not indicated for simultaneous bilateral breast reconstruction; it is the main drawback of this technique. So we believe that this procedure is an excellent alternative in all the indications of sequential bilateral breast reconstructions.
本研究旨在分析自体背阔肌肌皮瓣双侧乳房重建的优缺点及效果。
1993年至2001年期间，同一位手术医生连续进行了31例两阶段双侧乳房重建手术。所有重建手术均在乳腺癌根治术或保乳根治术后即刻或延期进行。所有病例均采用自体背阔肌肌皮瓣。为避免背部并发症，第二侧乳房的重建总是延迟数月。我们对这些患者的病历进行了回顾性分析。评估了术前数据、术后并发症、背部血清肿的发生情况、形态学结果及患者满意度。中位随访时间为22个月。
结果证实了该手术的可靠性。第一侧乳房和对侧乳房重建术后并发症的发生率比较无显著差异。双侧背阔肌切取后的功能后遗症较轻。84%的病例美学效果被评为非常好，16%为好。患者的满意率较高：90.3%满意，6.5%较满意，3.2%中度满意。
自体背阔肌肌皮瓣可用于两阶段双侧乳房重建。该手术不适用于同期双侧乳房重建；这是该技术的主要缺点。因此，我们认为在所有序贯双侧乳房重建的适应证中，该手术是一种极佳的选择。
