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侧胸壁穿支皮瓣在即刻和延迟乳房重建中的多功能性:26例临床经验回顾性研究

The Versatility of Lateral Chest Wall Perforator Flaps in Immediate and Delayed Breast Reconstruction: Retrospective Study of Clinical Experience with 26 Patients.

作者信息

Retrouvey Helene, Mahoney Mary-Helen, Pinchuk Brian, Jalil Waqqas, Somogyi Ron

机构信息

University of Toronto, North York General Hospital, Toronto, Ontario, Canada.

出版信息

Plast Surg (Oakv). 2023 Aug;31(3):261-269. doi: 10.1177/22925503211051110. Epub 2021 Dec 20.

Abstract

Lateral chest flaps represent versatile reconstructive options, especially valuable in times of global healthcare resource restriction. In this series, we present our experience with the use of lateral chest wall flaps in both immediate and delayed reconstruction from both breast conserving and mastectomy surgery. A retrospective cohort study of patients who had undergone a lateral chest wall flap for immediate or delayed breast reconstruction of a lumpectomy or mastectomy defect was performed. Data collected consisted of patient demographics, procedure type, tumor/oncological characteristics, as well as postoperative complications. Between September 2015 and April 2021, 26 patients underwent breast reconstruction using a lateral chest wall flap. Fifteen patients (58%) underwent immediate reconstruction (9 lumpectomy; 6 mastectomy) and 11 (42%) underwent delayed breast reconstruction. All flaps survived, though 1 patient required partial flap debridement following venous compromise hours after surgery. There were no incidences of hematoma, seroma, infection, or wound healing delay at either the donor site or breast. There was one positive margin which occurred in a mastectomy patient. This study describes the use of lateral chest wall flaps in a wide variety of reconstructive breast surgery scenarios. This technique can be safely performed in an outpatient setting and does not require microvascular techniques. Review of our outcomes and complications demonstrate that this is a safe and effective option. Our experience is that this is an easy to learn, versatile flap that could be a valuable addition to the surgeon's arsenal in breast reconstruction.

摘要

胸外侧皮瓣是一种多功能的重建选择,在全球医疗资源受限的情况下尤其有价值。在本系列研究中,我们介绍了在保乳手术和乳房切除术后即刻及延期重建中使用胸外侧壁皮瓣的经验。对因肿块切除或乳房切除术后缺损而接受胸外侧壁皮瓣即刻或延期乳房重建的患者进行了一项回顾性队列研究。收集的数据包括患者人口统计学资料、手术类型、肿瘤/肿瘤学特征以及术后并发症。2015年9月至2021年4月期间,26例患者使用胸外侧壁皮瓣进行了乳房重建。15例患者(58%)接受了即刻重建(9例肿块切除术;6例乳房切除术),11例(42%)接受了延期乳房重建。所有皮瓣均存活,不过1例患者在术后数小时出现静脉受压后需要进行部分皮瓣清创。供区或乳房均未发生血肿、血清肿、感染或伤口愈合延迟。1例乳房切除术患者出现切缘阳性。本研究描述了胸外侧壁皮瓣在各种乳房重建手术场景中的应用。该技术可在门诊安全实施,且不需要微血管技术。对我们的结果和并发症的回顾表明,这是一种安全有效的选择。我们的经验是,这是一种易于学习、多功能的皮瓣,可为外科医生的乳房重建技术库增添有价值的补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9b0/10467436/4ee6acf08d48/10.1177_22925503211051110-fig1.jpg

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