Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Surgery, School of Medicine, Kyungpook National University, kyungpook National University Chilgok Hospital, Daegu, 41404, Republic of Korea.
BMC Surg. 2022 Jul 28;22(1):294. doi: 10.1186/s12893-022-01741-6.
We conducted a prospective cohort study to evaluate effective techniques for breast reconstruction after partial mastectomy due to breast cancer. Determining the method of reconstruction is often difficult as it depends on the location of the cancer and the amount of tissue excised.. Here, we present a new technique, using the vertical latissimus dorsi (LD) flap, that can be used in all partial mastectomies and can almost conceal scarring. We also compared these results to those of the mini LD flap.
We analyzed the data of a total of 50 and 47 patients, who underwent breast reconstruction with the mini LD flap and the vertical LD flap, respectively. Immediately after tumor excision, breast reconstruction was initiated. The skin flap for vertical LD was designed in a planarian shape, such that it may be hidden as much as possible and minimize bulging during closure, and the LD muscle flap was designed with a sufficient distance in the inferior direction.
Our finding showed that the vertical LD flap group required significantly less total operation time than the mini LD flap group. While the mini-LD flap resulted in a scar that was difficult to conceal, the donor site scar of the vertical LD flap could not be seen easily, and no scar was visible on the back.
The vertical LD flap is useful for partial breast reconstruction, in all breast regions requires a rather small volume of the flap. Moreover, recovery was relatively fast with high patient satisfaction.
我们进行了一项前瞻性队列研究，以评估乳腺癌部分乳房切除术后乳房重建的有效技术。由于重建方法取决于癌症的位置和切除的组织量，因此确定重建方法通常很困难。在这里，我们提出了一种新的技术，使用垂直背阔肌（LD）皮瓣，可以用于所有部分乳房切除术，并几乎可以隐藏疤痕。我们还将这些结果与迷你 LD 皮瓣的结果进行了比较。
我们分析了总共 50 名和 47 名患者的资料，他们分别接受了迷你 LD 皮瓣和垂直 LD 皮瓣的乳房重建。在肿瘤切除后立即开始进行乳房重建。垂直 LD 的皮瓣设计为 planarian 形状，以便尽可能隐藏，并在关闭时最小化隆起，并且 LD 肌肉皮瓣在下方设计有足够的距离。
我们的发现表明，垂直 LD 皮瓣组的总手术时间明显少于迷你 LD 皮瓣组。虽然迷你-LD 皮瓣导致难以隐藏的疤痕，但垂直 LD 皮瓣的供体部位疤痕不易看到，背部也没有疤痕。
垂直 LD 皮瓣适用于所有乳房区域的部分乳房重建，需要的皮瓣体积较小。此外，患者满意度高，恢复相对较快。
