Missana Marie C, Pomel Cristophe
Department of Surgical Oncology and Breast Reconstructive Surgery, Gustave Roussy Institute, Comprehensive Cancer Centre, 39 Rue Camille Desmoulins, 94 800 Villejuif, France.
Am J Surg. 2007 Aug;194(2):164-9. doi: 10.1016/j.amjsurg.2006.10.029.
Immediate breast reconstruction using the latissimus dorsi musculocutaneous flap is a standard technique that allows for cosmetically acceptable results yet leaves a great scar on the donor site. To reduce the scars, we have been using a different surgical technique consisting of endoscopic harvesting of the latissimus dorsi pure muscular flap with a virtual cavity created by CO2 gas distention.
Between May 1, 2001, and June 30, 2005, there were 52 patients who underwent latissimus dorsi endoscopic harvesting for an immediate breast reconstruction after a skin-sparing mastectomy.
The mean surgical endoscopic time was 64 minutes. There was one conversion to an open technique. We reported no deaths, but complications included 2 hematomas, 6 inflammatory syndromes, and 1 pulmonary embolism.
The endoscopic harvesting of the latissimus dorsi flap when performed with this mixed technique is feasible, reproducible, and permits a significant reduction of incision size and postoperative pain, with good aesthetic results.
使用背阔肌肌皮瓣进行即刻乳房重建是一种标准技术，可获得美容上可接受的效果，但会在供区留下较大瘢痕。为减少瘢痕，我们一直在使用一种不同的手术技术，即通过二氧化碳气体膨胀创建虚拟腔隙，在内镜下切取背阔肌纯肌瓣。
在2001年5月1日至2005年6月30日期间，有52例患者在保乳皮肤切除术后接受了背阔肌内镜切取以进行即刻乳房重建。
平均手术内镜时间为64分钟。有1例转为开放技术。我们报告无死亡病例，但并发症包括2例血肿、6例炎症综合征和1例肺栓塞。
采用这种混合技术进行背阔肌瓣的内镜切取是可行的、可重复的，能显著减小切口尺寸并减轻术后疼痛，且美容效果良好。
