Kubo Kazuyuki, Takei Hiroyuki, Hamahata Atsumori
Division of Breast Surgery, Saitama Cancer Center.
Department of Breast Surgery and Oncology, Nippon Medical School.
J Nippon Med Sch. 2021 Mar 11;88(1):63-70. doi: 10.1272/jnms.JNMS.2021_88-204. Epub 2020 Apr 30.
In patients undergoing mastectomy for locally advanced breast cancer (LABC), surgical skin flap reconstruction is sometimes required in order to cover large skin defects. This study assessed the efficacy of local, cutaneous (rhomboid) flap reconstruction after mastectomy by comparing data from patients with LABC requiring local flap reconstruction after mastectomy and those that underwent mastectomy alone.
Data from 68 patients with LABC who underwent mastectomy were reviewed retrospectively; 14 underwent local (rhomboid) flap reconstruction after mastectomy (local flap group) and 54 underwent direct closure after mastectomy (direct closure group). A pinch test was performed to determine the closure method. Data on the operation, postoperative complications, and postoperative quality of life (QOL) were compared between groups.
It was possible to close defects in the local flap group that were significantly larger than those in the direct closure group (p=0.0002). There was no significant difference in postoperative complications between groups. Although operative duration was significantly longer in the local flap group than in the direct closure group (p=0.016), the average difference was only 25 minutes. There was no significant difference in variables related to postoperative QOL.
Rhomboid flap reconstruction was effective for covering large defects after mastectomy in patients with LABC.
对于接受局部晚期乳腺癌（LABC）乳房切除术的患者，有时需要进行手术皮瓣重建以覆盖大面积皮肤缺损。本研究通过比较LABC患者乳房切除术后需要局部皮瓣重建的患者与仅接受乳房切除术的患者的数据，评估乳房切除术后局部菱形皮瓣重建的疗效。
回顾性分析68例接受乳房切除术的LABC患者的数据；14例患者在乳房切除术后接受局部（菱形）皮瓣重建（局部皮瓣组），54例患者在乳房切除术后直接缝合（直接缝合组）。进行捏压试验以确定闭合方法。比较两组患者的手术、术后并发症和术后生活质量（QOL）数据。
局部皮瓣组能够闭合明显大于直接缝合组的缺损（p = 0.0002）。两组术后并发症无显著差异。虽然局部皮瓣组的手术时间明显长于直接缝合组（p = 0.016），但平均差异仅为25分钟。与术后QOL相关的变量无显著差异。
菱形皮瓣重建对LABC患者乳房切除术后覆盖大的缺损有效。
