Fauconnier M B, Burnier P, Jankowski C, Loustalot C, Coutant C, Vincent L
Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion street, 21000 Dijon, France.
Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion street, 21000 Dijon, France.
J Plast Reconstr Aesthet Surg. 2022 Oct;75(10):3653-3663. doi: 10.1016/j.bjps.2022.06.084. Epub 2022 Jul 23.
Breast reconstruction is becoming increasingly important in the management of breast cancer. Among breast reconstruction with flap, latissimus dorsi flap is the most frequent technique used in France. Lipofilling's emergence led to changes for using latissimus dorsi flap in breast reconstruction. The aim of this study was to compare postoperative complications following conventional latissimus dorsi (CLD) flap versus muscle-sparing latissimus dorsi (MSLD) flap breast reconstruction.
Data from 96 patients, who underwent CLD flap or MSLD flap breast reconstruction, were retrospectively collected from January 2018 to December 2019 in Georges-Francois Leclerc Cancer Center in France. Uni- and multivariate analyses, using a logistic regression, were performed to define operative factors and postoperative morbidity associated with surgical technique and evaluate whether MSLD flap could be associated with less postoperative outcome.
After univariate analysis, factors significantly associated with MSLD flap were reduced surgical time (p<0.001), reducing seroma and punctures (p<0.001), postoperative complications of donor site (p=0.09), and a shorter length hospital stay (p<0.001). After multivariate analysis, a shorter length hospital stay was significantly associated with the muscle-sparing group (OR=0.47, 95% CI (0.30-0.73), p<0.001).
This is the first French study comparing postoperative complications following the two techniques of latissimus dorsi flap breast reconstruction. In this study, the hospital stay was significantly decreased with MSLD flap compared with the CLD flap breast reconstruction. Both seem to be reliable methods with few complications.
乳房重建在乳腺癌治疗中变得越来越重要。在皮瓣乳房重建中，背阔肌皮瓣是法国最常用的技术。脂肪填充的出现导致了背阔肌皮瓣在乳房重建中的使用发生了变化。本研究的目的是比较传统背阔肌（CLD）皮瓣与保留肌肉的背阔肌（MSLD）皮瓣乳房重建术后的并发症。
回顾性收集了2018年1月至2019年12月在法国乔治 - 弗朗索瓦·勒克莱尔癌症中心接受CLD皮瓣或MSLD皮瓣乳房重建的96例患者的数据。采用逻辑回归进行单因素和多因素分析，以确定与手术技术相关的手术因素和术后发病率，并评估MSLD皮瓣是否与较少的术后不良结果相关。
单因素分析后，与MSLD皮瓣显著相关的因素包括手术时间缩短（p<0.001）、血清肿和穿刺减少（p<0.001）、供区术后并发症（p = 0.09）以及住院时间缩短（p<0.001）。多因素分析后，住院时间缩短与保留肌肉组显著相关（OR = 0.47，95% CI（0.30 - 0.73），p<0.001）。
这是法国第一项比较两种背阔肌皮瓣乳房重建技术术后并发症的研究。在本研究中，与CLD皮瓣乳房重建相比，MSLD皮瓣显著缩短了住院时间。两者似乎都是可靠的方法，并发症较少。
