Periareolar skin-sparing mastectomy and latissimus dorsi flap with biodimensional expander implant reconstruction: Surgical planning, outcome and complications
Periareolar skin-sparing mastectomy and latissimus dorsi flap with biodimensional expander implant reconstruction: Surgical planning, outcome and complications
复制标题
DOI：
10.1097/01.prs.0000246406.68739.e4
复制
发表时间：
2007-05-01
影响因子：
3.6
通讯作者：
Ferreira, Marcus Castro
中科院分区：
文献类型：
--
作者：
Munhoz, Alexandre Mendonca;Aldrighi, Claudia;Ferreira, Marcus Castro
背景：虽然使用与 BioDimension 解剖扩张器植入系统 (McGhan 150) 相关的背阔肌肌皮瓣是一种可靠的技术，但关于乳晕周围皮肤保留乳房切除术重建后的临床结果的信息很少。本研究的目的是分析保留皮肤乳房切除术后该技术的可行性、手术计划及其结果。方法：32 名患者接受即刻单侧背阔肌肌皮瓣/BioDimension 解剖扩张器植入系统乳房重建。平均随访时间为 18 个月。该技术适用于伴有或不伴有下垂的小或中等体积乳房的患者，在这些患者中不能使用腹部皮瓣。评估皮瓣和供体部位的并发症。收集有关麻醉结果和患者满意度的信息。结果：根据美国癌症联合委员会标准，72% 的肿瘤尺寸为 2 厘米或更小 (T1)，78% 的肿瘤处于 0 期和 I 期。乳房皮肤并发症的发生率为 9.4%。两名患者出现小乳房皮肤坏死，一名患者观察到伤口裂开。供体部位并发症（全部以血清肿为代表）的发生率为 12.5%。 84.4%的患者认为美容效果良好或非常好，大多数患者表示非常满意或满意。未观察到局部复发。除2例并发症外，其余并发症均采用保守治疗。结论：背阔肌肌皮瓣/BioDimension解剖扩张器植入系统是乳晕周围皮肤保留乳房切除术重建的一种简单可靠的技术。成功取决于患者的选择、与肿瘤外科医生的协调计划以及仔细的术中和术后管理。
Background: Although use of the latissimus dorsi myocutaneous flap associated with the Biodimensional anatomical expander implant system (McGhan 150) is a reliable technique, little information has been available regarding clinical outcome following periareolar skin-sparing mastectomy reconstruction. The purpose of this study was to analyze the feasibility of the technique, surgical planning, and its outcome following skin-sparing mastectomy.Methods: Thirty-two patients underwent immediate unilateral latissimus dorsi myocutaneous flap/Biodimensional anatomical expander implant system breast reconstruction. Mean follow-up was 18 months. The technique was indicated in patients with small- or moderate-volume breasts with or without ptosis, in whom the use of abdominal flaps was precluded. Flap and donor-site complications were evaluated. Information on anesthetic results and patient satisfaction was collected.Results: Seventy-two percent had tumors measuring 2 cm or less (T1) and 78 percent were stage 0 and I according to American joint Committee on Cancer criteria. Breast skin complications occurred in 9.4 percent. Two patients presented small breast skin necrosis, and in one patient, a wound dehiscence was observed. Donor-site complications, all represented by seroma, occurred in 12.5 percent. The cosmetic result was considered good or very good in 84.4 percent, and the majority of patients were either very satisfied or satisfied. No local recurrences were observed. All complications except two were treated by conservative means.Conclusions: The latissimus dorsi myocutaneous flap/Biodimensional anatomical expander implant system is a simple and reliable technique for periareolar skin-sparing mastectomy reconstruction. Success depends on patient selection, coordinated planning with the oncologic surgeon, and careful intraoperative and postoperative management.