From the The Royal Wolverhampton NHS Trust, Wolverhampton.
Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust, Lincoln, United Kingdom.
Ann Plast Surg. 2022 Jan 1;88(1):14-19. doi: 10.1097/SAP.0000000000002838.
Oncoplastic breast surgery is well established in many parts of the world and is gaining popularity in the rest of the world. The cornerstone in oncoplastic breast surgery is to respect oncological principles during cancer resection maintaining good aesthetic and cosmetic outcome. With the advancement in local, regional, and systemic treatment for breast cancer, survival has improved, and patients live longer. It is utmost essential to help our patients to maintain a good quality of life. Aesthetic and cosmetic outcomes have a significant impact on patient's psychosocial, emotional, and sexual well-being.Oncoplastic techniques have evolved over the last decade with the increasing use of perforator flaps to enable partial breast reconstruction. We report the findings of a prospective cohort study using modified lateral intercostal artery perforator in partial breast reconstruction. This modified technique offers a less visible scar and good access to the axilla without any need for repositioning the patient during the operative procedure.
A retrospective review of a prospectively maintained database of patients who underwent partial breast reconstruction with a modified lateral intercostal artery perforator flap was carried out between July 2016 and January 2020 in 2 oncoplastic breast units. The study had local approval from the respective audit departments. Patient demographics, operative data, surgical complications, and outcomes were collected and analyzed.
Forty-one patients underwent the procedure between July 2016 and January 2020. The median age of the population data was 58 years (interquartile range, 9 years). There were 10 active smokers (24.4%), and 3 patients had diabetes mellitus (7.3%). Overall, 3 patients (7.1%) developed seroma, 1 had a hematoma (2.4%), and 1 had a locoregional recurrence (2.4%). Two patients (4.9%) underwent margin re-excision for close margins. Most patients (92%) had the procedure carried out as day-case surgery. None of the patients developed wound infection, necrosis, or flap loss. The results were comparable across the 2 participating units.
The data suggest that modified intercostal artery perforator flap is an excellent oncoplastic technique for volume replacement in partial breast reconstruction with a short learning curve and minimal perioperative morbidity.
在世界许多地区，肿瘤整形乳房手术已经得到广泛应用，并且在世界其他地区也越来越受欢迎。肿瘤整形乳房手术的基石是在进行癌症切除时尊重肿瘤学原则，同时保持良好的美学和美容效果。随着局部、区域和全身治疗乳腺癌的进步，患者的生存率得到提高，寿命也更长。帮助患者保持良好的生活质量至关重要。美学和美容效果对患者的社会心理、情感和性健康有着重要的影响。肿瘤整形技术在过去十年中不断发展，随着穿支皮瓣的广泛应用，部分乳房重建得以实现。我们报告了使用改良外侧肋间动脉穿支进行部分乳房重建的前瞻性队列研究结果。这种改良技术提供了更不显眼的疤痕，并可良好地进入腋窝，而在手术过程中无需重新定位患者。
对 2016 年 7 月至 2020 年 1 月期间在 2 个肿瘤整形乳房单位接受改良外侧肋间动脉穿支皮瓣部分乳房重建的患者前瞻性维护数据库进行回顾性审查。该研究获得了各自审计部门的地方批准。收集并分析了患者人口统计学数据、手术数据、手术并发症和结果。
2016 年 7 月至 2020 年 1 月期间，共有 41 例患者接受了该手术。人群数据的中位年龄为 58 岁（四分位距，9 岁）。有 10 例主动吸烟者（24.4%），3 例患者患有糖尿病（7.3%）。总体而言，有 3 例患者（7.1%）发生血清肿，1 例发生血肿（2.4%），1 例发生局部区域复发（2.4%）。有 2 例患者（4.9%）因切缘接近而行边缘再次切除术。大多数患者（92%）作为日间手术进行了该手术。无患者发生伤口感染、坏死或皮瓣坏死。两个参与单位的结果相似。
数据表明，改良肋间动脉穿支皮瓣是一种出色的肿瘤整形技术，用于部分乳房重建中的体积替代，具有较短的学习曲线和最小的围手术期发病率。
