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使用下腹部脂肪筋膜组织修复进行乳房重建的术后过程。

Postoperative courses of breast reconstruction using inferior adipofascial tissue repair.

作者信息

Otsuka Shoko, Watanabe Naoki, Sasaki Youko, Shimojima Reiko

机构信息

Department of Breast Surgery, Japanese Red Cross Society, Himeji Hospital, 1-12-1, Shimoteno, Himeji, Hyogo, 670-8540, Japan.

出版信息

Breast Cancer. 2015 Nov;22(6):570-7. doi: 10.1007/s12282-014-0522-6. Epub 2014 Jun 13.

DOI:10.1007/s12282-014-0522-6
PMID:24925523
Abstract

BACKGROUND

Nevertheless in breast conserving surgery, the dissection of inferior part of breast mound will cause severe deformity, which affects the patient's quality of life adversely. We have used an infra-mammary adipofascial tissue to repair the defect, and breast mound could be reconstructed concurrently in primary breast cancer surgery.

PATIENTS AND SURGICAL PROCEDURE

From September 2009 to June 2012, we performed the infra-mammary adipofascial tissue repair (IATR) on 25 patients with breast cancer in inferior site of their breast mound. Surgeon makes the skin incision on the infra-mammary line and performs the quadrantectomy as planned. After verifying its negative surgical margin pathologically, we mobilize the adipofascial fat tissue associated with myofascia of the serratus anterior muscle from the infra-mammary area. This tongue-shaped flap is reflected back, and fills the defect of breast mound. We performed routinely examination, mammography, and ultra-sound echogram to the IATR patients who visited our hospital after 1 year from the end of treatment. We, furthermore, performed the QOL questionnaire (QOL-ACD and QOL-ACD-B) to them and retrospectively compared their data to that from the other breast surgery patients.

RESULTS

All patients with IATR were treated with irradiation, and no image findings of a partial or total necrosis of the flap recognized 1 year after examination. They produced good cosmetic results; however, they could not elevate the QOL score on the whole.

摘要

背景

然而,在保乳手术中,乳房下皱襞部分的剥离会导致严重畸形,对患者的生活质量产生不利影响。我们使用乳房下脂肪筋膜组织修复缺损,并在原发性乳腺癌手术中同时重建乳房下皱襞。

患者与手术步骤

2009年9月至2012年6月,我们对25例乳房下皱襞部位患有乳腺癌的患者进行了乳房下脂肪筋膜组织修复术(IATR)。外科医生在乳房下皱襞线上做皮肤切口,并按计划进行象限切除术。在病理检查确认手术切缘阴性后,我们从乳房下区域游离与前锯肌肌筋膜相连的脂肪筋膜组织。将这个舌形皮瓣向后翻转,填充乳房下皱襞的缺损。我们对治疗结束1年后到我院就诊的IATR患者进行了常规检查、乳房X线摄影和超声心动图检查。此外,我们还对他们进行了生活质量问卷(QOL-ACD和QOL-ACD-B)调查,并将他们的数据与其他乳房手术患者的数据进行回顾性比较。

结果

所有接受IATR治疗的患者均接受了放疗,检查1年后未发现皮瓣部分或完全坏死的影像学表现。它们产生了良好的美容效果;然而,总体上它们并不能提高生活质量评分。

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