微创切取背阔肌皮瓣进行乳房重建：系统评价。
Minimally invasive harvest of the latissimus dorsi flap for breast reconstruction: A systematic review.
机构信息
Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, Palo Alto, California, USA.
出版信息
Int J Med Robot. 2022 Dec;18(6):e2446. doi: 10.1002/rcs.2446. Epub 2022 Aug 24.
BACKGROUND
Poor cosmetic results with oncoplastic and implant-based breast reconstruction have stimulated an interest in latissimus dorsi flap (LDF)-based reconstruction. We reviewed the surgical techniques and outcomes of the LDF harvested with minimally invasive surgery.
METHODS
A systematic search was conducted across PubMed-MEDLINE, Web of Science, Scopus, and Ovid-MEDLINE(R). Data on surgical outcomes were extracted.
RESULTS
31 articles were included reporting on 857 reconstructive procedures using a LDF harvested, 497 were endoscopic-assisted LDF (EALDF) (58%) and 174 were robotic-assisted LDF (RALDF) (20.3%). The average flap harvest time was 84.04-min for EALDF and 106.14-min for RALDF. With an EALDF, the incidence of haematoma, seroma, and wound dehiscence ranged between 0%-16.6%, 0%-48%, and 0%-6.2%, respectively. Using RALDF, the incidence of seroma was between 0%-26.1% and 0%-3.4% for haematoma.
CONCLUSIONS
While the indications for a LDF harvested with MIS are limited, its main advantage for breast reconstruction is the absence of the back scar.
背景
肿瘤整形和假体植入乳房重建后美容效果较差，这激发了人们对背阔肌皮瓣（LDF）重建的兴趣。我们回顾了微创外科中 LDF 的手术技术和结果。
方法
在 PubMed-MEDLINE、Web of Science、Scopus 和 Ovid-MEDLINE（R）中进行了系统检索。提取了手术结果的数据。
结果
有 31 篇文章报道了 857 例使用 LDF 进行的重建手术，其中 497 例为内镜辅助 LDF（EALDF）（58%），174 例为机器人辅助 LDF（RALDF）（20.3%）。EALDF 的平均皮瓣采集时间为 84.04 分钟，RALDF 的平均皮瓣采集时间为 106.14 分钟。EALDF 的血肿、血清肿和伤口裂开的发生率分别为 0%-16.6%、0%-48%和 0%-6.2%。使用 RALDF，血肿的发生率为 0%-26.1%，血清肿的发生率为 0%-3.4%。
结论
虽然微创外科中 LDF 的适应证有限，但它用于乳房重建的主要优点是没有背部疤痕。
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