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带网膜瓣的乳房微型重建:一项回顾性临床研究。

Mini-breast reconstruction with an omental flap: a retrospective clinical study.

作者信息

Kim Hoon, Yoon Chi Sun, Lee Hoon Bum, Ko Byung Kyun, Kim Gyu Yeol, Kim Kyu Nam

机构信息

Department of Plastic and Reconstructive Surgery, Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center, Daejeon, Korea.

Department of Plastic and Reconstructive Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

ANZ J Surg. 2017 Dec;87(12):E261-E265. doi: 10.1111/ans.13701. Epub 2016 Aug 3.

Abstract

INTRODUCTION

Potential challenges associated with immediate small breast reconstruction include an inadequate size of the donor site, a thinner skin envelope and limited selection of implants. We present immediate postmastectomy reconstruction of small breasts with a laparoscopically harvested pedicled omental flap (LHPOF) in five Korean women.

METHODS

From December 2014 to July 2015, we performed immediate postmastectomy reconstruction with an LHPOF in five breast cancer patients. Data on the patients' age; body mass index; tumour size; site, type and weight of the mastectomy specimen; operative time; hospital stay; complications; postoperative chemotherapy or radiation therapy; and follow-up duration were reviewed in this retrospective clinical study.

RESULTS

The mean mastectomy specimen weight was 212 g (range: 104-272 g). The mean operative time was 298 min (range: 240-380 min), and the mean harvesting time was 75 min (range: 65-90 min). There were no flap-related complications such as fat necrosis or flap loss and no donor site-related complications such as bowel dysfunction, an epigastric bulge or hernia during the follow-up period (average: 8.2 months, range: 5-11 months). The cosmetic results were satisfactory.

DISCUSSION

The LHPOF can be useful for immediate postmastectomy reconstruction of small breasts, because it provides a soft and naturally ptotic appearance of the reconstructed breast (versus implant-based reconstruction) with low donor-site morbidity (versus other autologous tissue reconstruction approaches).

摘要

引言

即刻小乳房重建相关的潜在挑战包括供区尺寸不足、皮肤包膜较薄以及植入物选择有限。我们报告了5例韩国女性采用腹腔镜获取的带蒂网膜瓣(LHPOF)进行即刻乳房切除术后小乳房重建的情况。

方法

2014年12月至2015年7月,我们对5例乳腺癌患者采用LHPOF进行了即刻乳房切除术后重建。在这项回顾性临床研究中,对患者的年龄、体重指数、肿瘤大小、乳房切除标本的部位、类型和重量、手术时间、住院时间、并发症、术后化疗或放疗以及随访时间等数据进行了回顾。

结果

乳房切除标本的平均重量为212克(范围:104 - 272克)。平均手术时间为298分钟(范围:240 - 380分钟),平均获取时间为75分钟(范围:65 - 90分钟)。在随访期间(平均:8.2个月,范围:5 - 11个月),未出现与皮瓣相关的并发症,如脂肪坏死或皮瓣丢失,也未出现与供区相关的并发症,如肠道功能障碍、上腹部隆起或疝气。美容效果令人满意。

讨论

LHPOF可用于即刻乳房切除术后小乳房重建,因为它能使重建乳房呈现柔软且自然下垂的外观(与基于植入物的重建相比),同时供区并发症发生率低(与其他自体组织重建方法相比)。

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