Myocutaneous versus thoraco-abdominal flap cover for soft tissue defects following surgery for locally advanced and recurrent breast cancer
Myocutaneous versus thoraco-abdominal flap cover for soft tissue defects following surgery for locally advanced and recurrent breast cancer
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DOI：
10.1002/jso.10236
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发表时间：
2003-05-01
影响因子：
2.5
通讯作者：
Asthana, S
中科院分区：
文献类型：
--
作者：
Deo, SVS;Purkayastha, J;Asthana, S
背景和目标：晚期乳腺癌根治性手术切除会产生较大的缺损，可能不适合一期缝合。在这种情况下，主要目的是迅速获得足够的软组织覆盖。各种方法，包括皮肤移植，网膜，随意皮瓣，肌皮瓣（MC），在过去已经尝试过，但是，没有共识的方法选择在这样的patients.Methods：一个回顾性分析的乳腺癌数据库的一个单一的手术单位进行，以找出需要额外的手术软组织覆盖的晚期乳腺癌患者的发病率。两个主要群体，“MC皮瓣”和“胸腹（TA）皮瓣，”进行了比较分析，在手术时间，失血量，发病率，住院时间，和最终outcome.Results：40（12.7%）的315例晚期乳腺癌患者接受手术需要额外的手术软组织覆盖。MC皮瓣18例，TA皮瓣22例。平均出血（192 +/- 77 ml vs. 40 +/- 19 ml），手术时间（110 +/- 20分钟vs. 35 +/- 7分钟）和住院时间（10 +/- 4天对5 - 2天）在TA皮瓣组中显著更少。目前的研究结果显示，在乳房切除术后需要TA和MC皮瓣进行软组织覆盖的患者之间，在失血量、手术时间和住院时间方面存在显著差异。鉴于其简单和更好的效果，我们建议TA皮瓣应作为首选皮瓣在晚期乳腺癌患者需要皮肤覆盖。
Background and Objectives: Radical surgical extirpation in advanced breast cancer patients produces large defects that may not be suitable for primary closure. The primary aim in such cases is to achieve an adequate soft tissue cover expeditiously. Various methods, including skin graft, omentum, random flaps, and myocutaneous (MC) flaps, have been tried in the past; however, there is no consensus regarding the method of choice in such patients.Methods: A retrospective analysis of the breast cancer database of a single surgical unit was performed to find out the incidence of advanced breast cancer patients requiring an additional surgical procedure for soft tissue cover. A comparative analysis of two major groups, "MC flaps" and "thoraco-abdominal (TA) flaps," was performed in relation to operative time, blood loss, morbidity, hospital stay, and final outcome.Results: Forty (12.7%) out of 315 advanced breast cancer patients undergoing surgery required additional surgical procedures for soft tissue cover. MC flaps were used in 18 patients and TA flaps were used in 22 patients. The mean blood loss (192 +/- 77 ml vs. 40 +/- 19 ml), operating time (110 +/- 20 minutes vs. 35 +/- 7 minutes), and hospital stay (10 +/- 4 days vs. 5 2 days) were significantly less in the TA flap group.Conclusions: The results of the current study show a significant difference in the blood loss, operating time, and hospital stay between patients requiring TA and MC flap for soft tissue cover following mastectomy. In view of its simplicity and better results, we recommend that the TA flap should be used as a first option flap in advanced breast cancer patients requiring skin cover.