[Autologous breast reconstruction with latissimus dorsi flap].
[Autologous breast reconstruction with latissimus dorsi flap].
复制标题
背阔肌皮瓣自体乳房再造术[J].
DOI：
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发表时间：
2000
期刊：
影响因子：
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通讯作者：
K. Clough
中科院分区：
文献类型：
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作者：
R. Rouzier;C. Louis‐Sylvestre;C. Nos;A. Fitoussi;K. Clough
自体乳房再造的金标准技术是横向腹直肌皮瓣（TRAM）。最近，背阔肌皮瓣的获取技术已被修改，以增加皮瓣，并允许乳房再造，而无需相关的植入物。本研究的目的是评价这种方法获得的美学效果，并评估与技术变化相关的早期发病率。1994年1月至1998年8月，43例患者接受了自体背阔肌皮瓣乳房再造。将其术后结果与30例采用背阔肌皮瓣联合植入物进行重建的患者进行比较。这43名患者被要求回来接受医生的美学评估，并回答有关美容效果的问卷调查。平均随访时间为18.6个月（范围8 - 60）。用这种技术重建的乳房平均大小为340 g（最高835 g）。背部血清肿是最常见的并发症（72%），其次是背部愈合延迟（19%）。与经典背阔肌皮瓣相比，血清肿的发生率显著增加（P = 0.003），但皮肤斯劳的出现率没有增加。93%的患者和77%的医生认为美学结果令人满意。结论：扩大背阔肌皮瓣可用于中小型乳房的再造，并具有良好的美学效果。此皮瓣似乎是一个有趣的替代TRAM皮瓣自体重建选定的患者。
The gold standard technique for autologous breast reconstruction is the transverse rectus abdominis flap (TRAM). Recently, techniques of harvesting a latissimus dorsi flap have been modified in such a way as to increase the flap and allow breast reconstruction without an associated implant. The aim of this study was to evaluate aesthetic results obtained with this method and to assess early morbidity related to the changes in the technique. Between January 1994 and August 1998, 43 patients underwent breast reconstruction with an autologous latissimus dorsi flap. Their postoperative outcome was compared to that of 30 patients who underwent reconstruction with a latissimus dorsi flap associated with an implant. These 43 patients were asked to come back for aesthetic evaluation by a physician and to answer a questionnaire about cosmetic results. Mean duration of follow-up was 18.6 months (range 8 to 60). Mean size of the breast reconstructed with this technique was 340 g (up to 835 g). Dorsal seroma was the most frequent complication (72%), followed by delayed dorsal healing (19%). The frequency of seroma was significantly increased when compared to a classic latissimus dorsi flap (P = 0.003), but frequency of skin slough was not. The aesthetic result was considered satisfactory in 93% of the cases by the patient and 77% of the cases by the physician. In conclusion, the extended latissimus dorsi flap allows reconstruction of small and medium size breasts, with a good aesthetic result. This flap appears to be an interesting alternative to the TRAM flap for autologous reconstruction in selected patients.