Yuan Huozhong, Xie Donghua, Xiao Xigang, Huang Xingwei
1 The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
2 Nova Southeastern University, Fort Lauderdale, FL, USA.
Surg Innov. 2017 Aug;24(4):349-352. doi: 10.1177/1553350617702309. Epub 2017 Apr 11.
To explore the clinical application of mastectomy with single incision followed by immediate laparoscopic-assisted breast reconstruction with latissimus dorsi muscle flap.
Fifteen women with primary early breast cancer, 3 women with breast ductal carcinoma in situ, and 7 women with severe plasma cell mastitis were treated with partial mastectomy or total mastectomy, sentinel lymph node biopsy, or axillary lymph node dissection through a breast lateral transverse incision. Subsequent breast reconstruction with latissimus dorsi muscle flap was assisted by laparoscopy. The patient's position, time used in dissecting latissimus dorsi muscle flap, size of latissimus dorsi muscle flap, postoperative complications, and the cosmetic results after reconstruction were assessed.
All the operations were well done through the breast lateral transverse incision and assistance of laparoscopy. The patient's position was changed only once during the operation. It took 1.5 to 2 hours to dissect latissimus dorsi muscle flap. The sizes of the latissimus dorsi muscle flap were 5 to 8 × 12 to 16 cm. There were no serious postoperative complications noted. The patients were satisfied with the appearance of the breasts and the small surgical scar.
The surgical approach introduced is minimally invasive with concealed scar and outstanding cosmetic results. It is worth promoting in clinical application.
探讨单切口乳房切除术联合腹腔镜辅助背阔肌肌皮瓣即刻乳房重建术的临床应用。
对15例原发性早期乳腺癌患者、3例乳腺导管原位癌患者和7例重度浆细胞性乳腺炎患者,经乳房外侧横切口行部分乳房切除术或全乳房切除术、前哨淋巴结活检或腋窝淋巴结清扫术。随后通过腹腔镜辅助行背阔肌肌皮瓣乳房重建术。评估患者体位、背阔肌肌皮瓣游离时间、背阔肌肌皮瓣大小、术后并发症及重建后的美容效果。
所有手术均通过乳房外侧横切口并在腹腔镜辅助下顺利完成。术中患者体位仅改变一次。背阔肌肌皮瓣游离时间为1.5至2小时。背阔肌肌皮瓣大小为5至8×12至16厘米。未发现严重术后并发症。患者对乳房外观及微小手术瘢痕满意。
所介绍的手术方法具有微创、瘢痕隐蔽及美容效果突出的特点,值得在临床应用中推广。