Delay E, Gounot N, Bouillot A, Zlatoff P, Comparin J P
Unité de Chirurgie Plastique et Reconstructrice, Centre Léon-Bérard, Lyon.
Ann Chir Plast Esthet. 1997 Apr;42(2):118-30.
Many women who have undergone or will undergo mastectomy request breast reconstruction and feel that it is an important part of their total cancer treatment. Autogenous tissue methods take a place more and more important in breast reconstruction. The autologous latissimus dorsi flap, is a recent method of autologous breast reconstruction. We have done a retrospective study based on a series of 60 consecutive reconstructions operated between march 1993 and april 1995. The advantages of the autologous latissimus dorsi flap are the same of the others autologous breast reconstruction methods: the reconstructed breasts are soft and match an opposite normal breast more successfully than those made with implants. The disadvantages of this technique is mainly the dorsal seroma that was observed in 70% of cases but was easily managed by aspirations. The aesthetics results have been judged by two surgeons as very good in 85% of cases, good in 11.6% and low in 3.3%. The satisfaction rate of the patients in high: 86.6% are pleased and 13.3% are satisfied. The autologous latissimus dorsi breast reconstruction is a safe and reliable technique and provides an excellent alternative to the TRAM flap, when the patient prefer the dorsal donor site or when there are some risk factors to do a TRAM flap. Finally this technique bring a major advance in the field of breast reconstruction, immediate or delayed.
许多已经接受或即将接受乳房切除术的女性要求进行乳房重建，并认为这是她们整个癌症治疗的重要组成部分。自体组织方法在乳房重建中占据着越来越重要的地位。背阔肌自体皮瓣是一种最新的自体乳房重建方法。我们基于1993年3月至1995年4月间连续进行的60例重建手术进行了一项回顾性研究。背阔肌自体皮瓣的优点与其他自体乳房重建方法相同：重建后的乳房柔软，与对侧正常乳房的匹配度比使用植入物的乳房更高。该技术的缺点主要是背部血清肿，在70%的病例中观察到，但通过抽吸很容易处理。两位外科医生对美学效果的评价为：85%的病例非常好，11.6%的病例良好，3.3%的病例较差。患者的满意度很高：86.6%的患者满意，13.3%的患者感到满意。背阔肌自体乳房重建是一种安全可靠的技术，当患者更喜欢背部供区或存在一些进行横行腹直肌肌皮瓣（TRAM瓣）的风险因素时，可以为TRAM瓣提供极佳的替代方案。最后，这项技术在即时或延迟乳房重建领域带来了重大进展。
