Abbes M, Mateu J, Giordano P, Bourgeon Y
Service de Chirurgie Carcinologique et Plastique, Centre Antoine Lacassagne, Nice.
Ann Chir. 1990;44(8):673-80.
The authors discuss the development of their approach to the repair of full-thickness chest wall resection based on a series of twenty-two patients operated between 1967 and 1989. The defect resulting from resection of all tissue planes, either for breast in situ, recurrences, radiation lesions or primary tumours, raises difficult problems. Mammary or cutaneous autoplasties, performed during the early years, have become less frequent, essentially because of the development of musculo-cutaneous flaps (pectoralis major, rectus abdominis, latissimus dorsi) which provide global anatomical and functional repair. The greater omentum island flap, used since 1974, still occupies an important place because of its plastic and trophic qualities in irradiated regions. When chest wall rigidity is compromised, Mersilene patch remains the material of choice. The quality of the results obtained in terms of comfort justifies the use of this major surgery which is now well defined.
作者基于1967年至1989年间接受手术的22例患者,讨论了他们修复全层胸壁切除的方法的发展。因切除所有组织层面而导致的缺损,无论是针对原位乳腺癌、复发癌、放射性损伤还是原发性肿瘤,都会引发难题。早年进行的乳房或皮肤自体移植术已变得不那么常见,主要是因为肌皮瓣(胸大肌、腹直肌、背阔肌)的发展,这些肌皮瓣可提供全面的解剖和功能修复。自1974年起使用的大网膜岛状皮瓣,因其在受辐射区域的塑形和营养特性,仍占据重要地位。当胸壁刚性受损时,涤纶补片仍是首选材料。就舒适度而言所获得的结果质量证明了这种现已明确的大型手术的应用合理性。