Yoshikawa K, Enomoto H
Department of Surgery, Sumitomo Hospital, Osaka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Oct;38(10):2148-51.
A 64 years old woman with anterior chest wall recurrence after bilateral mastectomy for breast cancer was treated by the resection of chest wall in full thickness involving the whole sternum and the anterior part of ribs except the first rib. The thoracic cage was reconstructed using a free rectus abdominis myocutaneous flap which was placed over Marlex mesh covering the defect of chest wall. By means of surgical microscope, inferior epigastric artery and vein of the graft were anastomosed with internal thoracic artery and vein at the neck, respectively. Postoperative course was uneventful and the patient is alive and well for one year after the surgery. A free myocutaneous flap method provides enough volume of soft tissue for coverage of a large defect and chest wall stability.
一名64岁女性,在双侧乳腺癌乳房切除术后出现前胸壁复发,接受了全层胸壁切除术,切除范围包括整个胸骨以及除第一肋外的肋骨前部。使用游离腹直肌肌皮瓣重建胸廓,将其置于覆盖胸壁缺损的Marlex网片上。借助手术显微镜,将移植物的腹壁下动静脉分别与颈部的胸廓内动静脉进行吻合。术后过程顺利,患者术后一年存活且状况良好。游离肌皮瓣方法可为覆盖大的缺损提供足够的软组织量并维持胸壁稳定性。