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[背阔肌肌皮瓣乳房重建:理念的演变]

[Breast reconstruction by latissimus dorsi flap: Towards an evolution of ideas].

作者信息

Niddam J, Guihard T, Cothier-Savey I, Chaussard H, Lemasurier P

机构信息

Centre de lutte contre le cancer René-Huguenin, institut Curie, 35, rue Dailly, 92210 Saint-Cloud, France.

Centre de lutte contre le cancer René-Huguenin, institut Curie, 35, rue Dailly, 92210 Saint-Cloud, France.

出版信息

Ann Chir Plast Esthet. 2015 Dec;60(6):506-11. doi: 10.1016/j.anplas.2014.09.015. Epub 2014 Nov 6.

DOI:10.1016/j.anplas.2014.09.015
PMID:25455801
Abstract

AIM OF THE STUDY

Breast reconstruction with latissimus dorsi flap and fat grafting is a technique widely used in current practice. Some operators still complain at the lack of final results at the first intervention and the need for repeated lipofilling sessions. The objective of this study was to compare the number of reoperations in patients who underwent reconstruction with latissimus dorsi with prosthesis versus without prosthesis.

PATIENTS AND METHODS

We included all patients operated for breast reconstruction with latissimus dorsi flap, with or without prosthesis between 2008 and 2012 in our center. We noted the number of new surgical interventions in these patients on the reconstructed breast. We also noted the average weight of mastectomy in two groups each year.

RESULTS

One hundred and eighty-six patients were included in this study. Ninety-one patients underwent reconstruction with latissimus dorsi and prosthesis, and 95 patients reconstruction by latissimus dorsi and fat graft. It has not been demonstrated significant differences in the number of new surgical procedures between the two groups. The average weight of mastectomies in the autologous group has steadily increased over the five years. There was no significant difference in the average weight of mastectomies between the two groups over the last two years.

CONCLUSION

For breast reconstruction with latissimus dorsi flap, surgical indications changed in our center to the absence of prosthetic implant, whatever the volume of the breast.

摘要

研究目的

背阔肌肌皮瓣联合脂肪移植进行乳房重建是目前广泛应用的一项技术。一些术者仍抱怨首次手术的最终效果欠佳以及需要多次进行脂肪填充手术。本研究的目的是比较接受带假体背阔肌重建与不带假体背阔肌重建患者的再次手术次数。

患者与方法

我们纳入了2008年至2012年期间在本中心接受背阔肌肌皮瓣乳房重建手术的所有患者,无论是否使用假体。我们记录了这些患者在重建乳房上进行的新手术干预次数。我们还记录了两组每年乳房切除术的平均重量。

结果

本研究共纳入186例患者。91例患者接受了带假体的背阔肌重建,95例患者接受了背阔肌联合脂肪移植重建。两组新手术操作次数未显示出显著差异。自体组织组乳房切除术的平均重量在五年内稳步增加。在过去两年中,两组乳房切除术的平均重量没有显著差异。

结论

对于采用背阔肌肌皮瓣进行乳房重建,无论乳房体积如何,我们中心的手术指征已转变为不使用假体植入物。

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