Wan Nengbin, Liu Dequan, Lu Lingli, He Xiao, Song Dajiang, Li Zan, Zhou Xiao, Peng Wen, Liu Zeyang
Department of Breast Surgery, Hunan Cancer Hospital, Changsha Hunan, 410008,
The First Department of Breast Surgery, Yunnan Province Cancer Hospital, the Third Affiliated Hospital of Kunming School of Medicine, Kunming Yunnan, 650000, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug 15;33(8):1006-1010. doi: 10.7507/1002-1892.201901007.
To explore the clinical application of the pedicled omentum flap in breast reconstruction of breast cancer patients.
Between May 2013 and October 2017, 205 patients with breast cancer received modified mastectomy. The pedicled omentum flap was used to reconstruct breast at the same time. All patients were female with an average age of 34.9 years (mean, 26-58 years). The tumor located at left breast in 127 cases and right side in 78 cases. The diameter of the tumor was 2-5 cm (mean, 2.9 cm). The 120 cases of breast cancer were at stage Ⅰ and 85 cases were at stage Ⅱ; and 126 cases were invasive ductal carcinoma and 79 cases were invasive lobular carcinoma. The course of disease ranged from 10 to 92 days (mean, 38.5 days). The size of defect after tumor ablation ranged from 9 cm× 6 cm to 18 cm×12 cm; the size of pedicled omentum flap ranged from 18 cm×10 cm to 22 cm×16 cm.
According to the anatomical basis, the omentum was divided into 4 types, including thin type (42 cases, 20.5%), medium type (133 cases, 64.9%), hypertrophy type (24 cases, 11.7%), and absence type (6 cases, 2.9%). All omentum flaps survived successfully and the incisions healed by first intention. All patients were followed up 6-74 months (mean, 24.5 months); 83 cases were followed up more than 5 years. The shape, texture, and elasticity of the reconstructed breast were good and no flap contracture deformation happened. Only linear scar left at the donor sites, and the function of abdomen was not affected. No local recurrence happened.
The pedicled omentum flap can be harvested safely and reliable, which is the one of ideal option for breast reconstruction in breast cancer patients.
探讨带蒂大网膜瓣在乳腺癌患者乳房重建中的临床应用。
2013年5月至2017年10月,205例乳腺癌患者行改良乳房切除术,同期采用带蒂大网膜瓣进行乳房重建。所有患者均为女性,平均年龄34.9岁(范围26 - 58岁)。肿瘤位于左侧乳房127例,右侧乳房78例。肿瘤直径2 - 5 cm(平均2.9 cm)。Ⅰ期乳腺癌120例,Ⅱ期85例;浸润性导管癌126例,浸润性小叶癌79例。病程10 - 92天(平均38.5天)。肿瘤切除后缺损大小为9 cm×6 cm至18 cm×12 cm;带蒂大网膜瓣大小为18 cm×10 cm至22 cm×16 cm。
根据解剖学基础,大网膜分为4型,其中薄型42例(20.5%),中型133例(64.9%),肥厚型24例(11.7%),缺如型6例(2.9%)。所有大网膜瓣均顺利存活,切口一期愈合。所有患者随访6 - 74个月(平均24.5个月);83例随访超过5年。重建乳房的外形、质地及弹性良好,未发生皮瓣挛缩变形。供区仅留线性瘢痕,腹部功能未受影响。无局部复发。
带蒂大网膜瓣切取安全可靠,是乳腺癌患者乳房重建的理想选择之一。