Kim Do Gon, Choi Dong Hun, Lee Joon Seok, Lee Jeong Woo, Lee Jeeyeon, Park Ho Yong, Yang Jung Dug
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Jung-gu, Daegu, South Korea.
Department of Surgery, School of Medicine, Kyungpook National University, Jung-gu, Daegu, South Korea.
Plast Reconstr Surg Glob Open. 2021 Feb 3;9(2):e3381. doi: 10.1097/GOX.0000000000003381. eCollection 2021 Feb.
The lateral thoracodorsal (LTD) flap technique is a type of oncoplastic breast surgery that involves transposition of tissue from the lateral aspect of a partial mastectomy defect. It is a relatively simple procedure and shows lower donor morbidity and good aesthetic outcomes. Complications, such as fat necrosis and wound dehiscence due to poor circulation, may occur at the distal part of the flap. We used a supercharged LTD flap to reduce this problem. In this study, the outcomes of the LTD flap over 13 years were reviewed.
We performed a retrospective study of 86 patients who underwent an LTD flap procedure between 2007 and 2019. We analyzed patient information using medical chart review and classified patients into groups according to lateral thoracic artery perforator supercharging. The incidence of complications, such as fat necrosis and wound dehiscence, was also analyzed.
The mean tumor weight was 83.67 g, and defects had a moderate size, as they represented 25.02% of the total breast volume. Fat necrosis was noted in 19.4% of cases in the group without lateral thoracic artery perforator supercharging and 4% of cases in the group with supercharging, with a significantly lower rate in the supercharged group.
Our findings show that the LTD flap could be used to cover moderate-sized defects after breast-conserving surgery. Careful dissection to preserve the lateral thoracic artery perforator resulted in the reduction of complications, such as fat necrosis, and excellent aesthetic results.
胸背外侧（LTD）皮瓣技术是一种肿瘤整形乳房手术，涉及将部分乳房切除术缺损外侧的组织进行移位。这是一种相对简单的手术，供区并发症发生率较低，美学效果良好。皮瓣远端可能会出现脂肪坏死和因血运不佳导致的伤口裂开等并发症。我们采用了带蒂胸背外侧皮瓣来减少这一问题。在本研究中，回顾了13年来胸背外侧皮瓣的手术效果。
我们对2007年至2019年间接受胸背外侧皮瓣手术的86例患者进行了回顾性研究。通过查阅病历分析患者信息，并根据胸外侧动脉穿支带蒂情况将患者分组。还分析了脂肪坏死和伤口裂开等并发症的发生率。
肿瘤平均重量为83.67克，缺损大小适中，占乳房总体积的25.02%。未进行胸外侧动脉穿支带蒂的组中，19.4%的病例出现脂肪坏死，带蒂组中这一比例为4%，带蒂组的发生率显著较低。
我们的研究结果表明，胸背外侧皮瓣可用于保乳手术后覆盖中等大小的缺损。仔细解剖以保留胸外侧动脉穿支可减少脂肪坏死等并发症，并获得优异的美学效果。
