Ahmed Ahmed S, Mohamed Mohamed A K, Mostafa Hesham S, El Naggar Abdel Naser M E, Ali Abdel Halim M A, Ahmed Ahmed Safaa, Ibrahim Mostafa F
From the General Surgery Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Plastic Surgery Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Plast Reconstr Surg Glob Open. 2024 Aug 26;12(8):e6065. doi: 10.1097/GOX.0000000000006065. eCollection 2024 Aug.
Emerging as an adjunct to breast-conserving surgery, oncoplastic breast surgery seeks to improve the cosmetic and functional outcomes for breast cancer surgery. The objective was to assess the potential advantages of using the latissimus dorsi (LD) flap, in comparison with local tissue rearrangement, in terms of aesthetic results and postoperative problems.
This study compared the outcomes of patients with a malignant tumor removed from the upper outer quadrant of the breast using a comparative nonrandomized control approach. Participants were split into two groups: reconstruction using local tissue rearrangement was performed on 20 patients (group A), and a pedicled LD flap was used to treat the same number of patients (group B). All patients were examined in the clinics' outpatient setting. Every 3 months, the medical oncology team would do a thorough clinical assessment.
Better aesthetic outcomes were significantly higher among patients with an LD flap. The LD flap was able to maintain breast shape in 90%, breast volume in 85%, and the nipple-areola complex direction in 90% of patients. Surgeons' evaluation of both techniques reported significantly higher satisfaction for LD flap than local tissue replacement. Patient satisfaction was significantly higher among patients with an LD flap. With regard to the postoperative complications, there were no significant differences between either group.
Oncoplastic breast surgery with reconstruction using the pedicled LD flap provides maintenance of the shape of female breasts with better aesthetic outcomes and patient and surgeon satisfaction than reconstruction using local tissue rearrangement, with a comparable complication rate.
肿瘤整形乳房手术作为保乳手术的辅助手段应运而生，旨在改善乳腺癌手术的美容和功能效果。本研究的目的是评估与局部组织重排相比，使用背阔肌（LD）皮瓣在美学效果和术后问题方面的潜在优势。
本研究采用比较性非随机对照方法，比较了从乳房外上象限切除恶性肿瘤患者的治疗结果。参与者分为两组：20例患者采用局部组织重排进行重建（A组），相同数量的患者采用带蒂LD皮瓣治疗（B组）。所有患者均在门诊进行检查。每3个月，肿瘤内科团队会进行一次全面的临床评估。
接受LD皮瓣手术的患者美学效果更佳。LD皮瓣能够使90%的患者保持乳房形状，85%的患者保持乳房体积，90%的患者保持乳头乳晕复合体方向。外科医生对两种技术的评估显示，对LD皮瓣的满意度明显高于局部组织置换。接受LD皮瓣手术的患者满意度明显更高。关于术后并发症，两组之间没有显著差异。
与使用局部组织重排进行重建相比，采用带蒂LD皮瓣进行重建的肿瘤整形乳房手术能够更好地维持女性乳房形状，具有更好的美学效果以及患者和外科医生满意度，且并发症发生率相当。
