Hwang C Y, Yeh F L, Lin J T, Fang R H
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 Nov;56(5):356-60.
Reconstruction of a chest wall defect remains a challenging problem, especially where such defects are radiation related. Two cases of modified breast flaps associated with pectoralis major muscle were performed to cover a huge mediastinal defect, with heart lung exposure and a post-mastectomy radiation-related chest wall defect with partial rib resection. Both modified breast flaps healed uneventfully. No respiratory distress was encountered post-operatively. The breast flap associated with pectoralis major muscle ensured flap reliability and minimized flap complication. It is easy to raise and its size is large enough to cover of large chest wall defect which is radiation related, or those internal mammary arteries and thoracodorsal arteries compromised in previous surgery where the transverse rectus abdominis myocutaneous (TRAM) flap and latissimus dorsi flap become unreliable. In such cases a contralateral modified breast flap associated with pectoralis major muscle is the better choice.
胸壁缺损的重建仍然是一个具有挑战性的问题，尤其是与放疗相关的缺损。我们进行了两例与胸大肌相关的改良乳房皮瓣手术，以覆盖巨大的纵隔缺损、心肺暴露以及乳房切除术后放疗相关的部分肋骨切除的胸壁缺损。两个改良乳房皮瓣均顺利愈合。术后未出现呼吸窘迫。与胸大肌相关的乳房皮瓣确保了皮瓣的可靠性并将皮瓣并发症降至最低。它易于掀起，其大小足以覆盖与放疗相关的大面积胸壁缺损，或那些在先前手术中胸廓内动脉和胸背动脉受损致使横行腹直肌肌皮瓣（TRAM瓣）和背阔肌皮瓣不可靠的情况。在这种情况下，对侧与胸大肌相关的改良乳房皮瓣是更好的选择。
