Cheung K L, Willsher P C, Robertson J F, Bailie F B, Daly J C, Blamey R W
Department of Surgery, Nottingham City Hospital, United Kingdom.
Aust N Z J Surg. 1997 Apr;67(4):185-6. doi: 10.1111/j.1445-2197.1997.tb01937.x.
The omentum has been employed to cover the defect produced after resection of gross breast cancer recurrence for nearly three decades.
A series of 11 patients undergoing omental transposition flap for very wide resection of gross local recurrence (LR) of breast cancer is reported. The median age was 39 years, with a short interval (median = 21 months) from the treatment of the primary tumour to LR. Local recurrence was gross and predominantly inflammatory.
All except one patient had lymphovascular invasion in the recurrent tumour. The omental graft was 100% viable but one patient required re-application of further split-thickness skin graft. The mean hospital stay was 16 days. Two cases of seroma formation were encountered. New recurrence developed around the periphery of the flap in eight patients after a median duration of local control of only 2.5 months. Eight patients died with metastatic disease after a median period of 6 months, six patients with uncontrolled local disease. Five patients were free from LR in over half of their remaining period of life.
Omentoplasty is a safe and reliable procedure but the length of palliation achieved is often far from satisfactory.
近三十年来，网膜一直被用于覆盖乳腺癌大块复发切除术后产生的缺损。
报告了一系列11例接受网膜转位皮瓣手术以对乳腺癌大块局部复发（LR）进行广泛切除的患者。中位年龄为39岁，从原发性肿瘤治疗到LR的间隔时间较短（中位值 = 21个月）。局部复发为大块且主要为炎性。
除1例患者外，所有复发性肿瘤均有淋巴管浸润。网膜移植物100%存活，但1例患者需要再次应用更薄的断层皮片移植。平均住院时间为16天。出现2例血清肿形成。8例患者在局部控制的中位持续时间仅2.5个月后，在皮瓣周边出现新的复发。8例患者在中位期6个月后死于转移性疾病，6例患者局部疾病未得到控制。5例患者在其剩余生命的一半以上时间内无局部复发。
网膜成形术是一种安全可靠的手术，但所实现的缓解期长度往往远不尽人意。
