Honart J-F, Leymarie N, Sarfati B, Alknashnam H, Rem K, Rimareix F, Kolb F
Service de chirurgie plastique et reconstructrice, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
Service de chirurgie plastique et reconstructrice, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
Ann Chir Plast Esthet. 2018 Feb;63(1):25-30. doi: 10.1016/j.anplas.2017.07.011. Epub 2017 Aug 10.
Even though DIEP-SIEA flaps or latissimus dorsi musculocutaneous flap are the most frequently used, a wide variety of flaps have been described for autologous breast reconstruction. Concerning the choice of donor-site, the aim is to prevent and to limit the morbidity. That is why the donor-site should be carefully chosen, according to the morphology of the patient. Lumbar artery perforator flap (LAP) is an option for breast reconstruction, but it is not well known and its use is limited. This study summarizes the authors' early experience with free LAP flap for breast reconstruction. Three patients underwent immediate or delayed autologous breast reconstruction using a LAP flap. No vascular by pass was required to lengthen the pedicle. No partial or complete flap necrosis has been reported. There was no surgical donor-site complication. Mean operative time was 7hours. LAP flap can be considered as a good option for autologous breast reconstruction, especially in patients with unfavorable abdominal donor-site, and impossibility to use a DIEP flap.
尽管腹壁下动脉穿支皮瓣（DIEP-SIEA瓣）或背阔肌肌皮瓣是最常用的，但已有多种皮瓣被描述用于自体乳房重建。关于供区的选择，目的是预防和限制并发症。这就是为什么应根据患者的形态仔细选择供区。腰动脉穿支皮瓣（LAP）是乳房重建的一种选择，但它并不广为人知且使用受限。本研究总结了作者使用游离LAP瓣进行乳房重建的早期经验。3例患者使用LAP瓣进行即刻或延迟自体乳房重建。无需血管搭桥来延长蒂部。未报告部分或完全皮瓣坏死。未出现手术供区并发症。平均手术时间为7小时。LAP瓣可被视为自体乳房重建的一个好选择，特别是对于腹部供区条件不佳且无法使用DIEP瓣的患者。
