Ogawa Tomoko, Hanamura Noriko, Yamashita Masako, Kimura Hiroko, Kashikura Yumi
Department of Breast Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
Breast Cancer. 2014 Sep;21(5):635-40. doi: 10.1007/s12282-011-0285-2. Epub 2011 Jun 28.
We have used an inframammary adipofascial flap for breast-conserving reconstruction in the inferior portion of the breast since 2005. The aim herein is to report this oncoplastic procedure in detail, including the long-term results. The surgical procedure was as follows: A skin incision is made at the inframammary line. After partial resection of the breast, a tongue-shaped flap of the fat and the anterior sheath of the rectus abdominis muscle are pulled up in the inframammary area. The flap is then inserted into the breast area where the tumor was removed, and it is secured with absorbable sutures to the surrounding breast tissue. When making the flap, it is very important to preserve several intercostal perforators around the inframammary line. Cosmetic results at more than 5 years after the operation in the 5 patients were assessed using photographs. The results were found to be good in 4 cases (80%) and poor in 1 case. The poor outcome was a case with 100% fat necrosis of the flap. This surgical procedure is easy to perform, and the long-term cosmetic outcomes were good, without complications. We consider this procedure to be useful for breast-conserving reconstruction after breast cancer occurring in the inferior portion of the breast.
自2005年以来，我们一直使用乳房下脂肪筋膜瓣对乳房下部进行保乳重建。本文旨在详细报告这种肿瘤整形手术，包括长期效果。手术步骤如下：在乳房下皱襞处做皮肤切口。乳房部分切除后，在乳房下区域掀起一块包含脂肪和腹直肌前鞘的舌形皮瓣。然后将该皮瓣插入切除肿瘤的乳房区域，并用可吸收缝线固定于周围乳腺组织。制作皮瓣时，保留乳房下皱襞周围的几根肋间穿支血管非常重要。通过照片评估了5例患者术后5年以上的美容效果。结果发现4例（80%）效果良好，1例效果较差。效果差的这例患者皮瓣出现了100%的脂肪坏死。该手术操作简便，长期美容效果良好，无并发症。我们认为该手术对乳房下部发生的乳腺癌保乳重建有用。
