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乳腺癌广泛局部切除术后即刻容积替代的胸廓内动脉穿支皮瓣

Internal Mammary Artery Perforator Flap for Immediate Volume Replacement Following Wide Local Excision of Breast Cancer.

作者信息

Huizum Martine A van, Hage J Joris, Oldenburg Hester A, Hoornweg Marije J

机构信息

Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Department of Surgical Oncology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

出版信息

Arch Plast Surg. 2017 Nov;44(6):502-508. doi: 10.5999/aps.2016.00458. Epub 2017 Oct 26.

Abstract

BACKGROUND

Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation.

METHODS

To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study.

RESULTS

We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site.

CONCLUSIONS

In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

摘要

背景

保乳治疗定义为对乳腺肿瘤进行保乳的广泛局部切除(WLE)并结合术后放疗。通过使用乳房缩小技术(体积移位)或组织置换技术(体积置换)立即恢复乳房形态以防止乳房畸形正变得越来越普遍。

方法

迄今为止,已有人建议使用胸廓内动脉穿支(IMAP)皮瓣在WLE后立即进行体积置换,但尚未在已发表的研究中进行评估。

结果

我们在12名女性(平均年龄56.1岁)乳房内侧进行WLE(平均标本重量46.5 g)后应用了该皮瓣。在中位随访35.3个月(标准差1.2个月)期间,4名女性需要再次手术以矫正供区的“狗耳”。

结论

根据我们的经验,使用IMAP皮瓣是一种可靠的技术,在肿瘤整形重建后具有良好的美容效果。在本系列中,最初往往证明有必要对供区进行修复,但我们表明这很容易预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/440f/5801778/fcfd6acca75a/aps-2016-00458f1.jpg

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