摘要
目的 探讨伴有剖宫产史的单蒂横行腹直肌肌皮瓣乳房再造术的手术方法、临床可行性及应用技术。方法 对9例剖宫产后不同时间的乳腺癌患者，在乳腺癌仿根治术后，采用即刻转移对侧单蒂横行腹直肌肌皮瓣进行乳房再造手术，腹壁横梭形皮瓣的上切口位于脐上1～2cm，下切口于下腹壁纵行切口瘢痕的中下1／3，切取以对侧腹直肌为单蒂的下腹壁皮瓣，转移至胸壁缺损部位，修整塑造乳房外形。结果9例乳房再造术患者转移的单蒂横行腹直肌肌皮瓣完全成活，再造乳房形态自然，外形逼真，无皮瓣坏死发生。2例保留乳头者发生乳头缺血，部分坏死脱落后愈合。结论 单蒂横行腹直肌肌皮瓣乳房再造术，对于有剖宫产史的乳腺癌患者并非绝对禁忌证，在做好术前充分评估的基础上，可以安全选择应用。
Objective To study the operation and the clinical application of breast reconstruction with the uni-pedical transverse rectus abdominis in breast cancer patients with caesarotomy. Methods Nine cases of breast reconstruction with uni-pedical transverse rectus abdominis post breast mastectomy had been undertaken in breast patients with a history of different caesarean birth. All cases were immediate reconstruction. Superior bound of abdomen horizontal shuttle flap was located 1 - 2 cm in front of navel, and lower bound of abdomen horizontal shuttle flap was located down 1/3 of lower abdomen vertical scar. The abdomen skin and subcutaneous tissue were incised and the myocutaneous flap of contralateral rectus abdominis was transfered, which acted as a pedical of the flap, to defective area of the chest wall, and was repaired to form the figuration of breast. Results 9 cases of the reconstructive breast flap were survival, the morphologies were natural, the shapes were normal, and touch feeling was good. Only two cases nipple skin was partial necrosis, and healed after partial desquamation. Conclusions The breast reconstruction with uni-pedical transverse rectus abdominis myocutaneous flap was a good choice for breast cancer patients with caesarotomy scar. This method could be applied safely in the patients after the sufficient evaluation.
出处
《中华医学美学美容杂志》
2008年第1期15-17,共3页
Chinese Journal of Medical Aesthetics and Cosmetology
关键词
乳腺癌
乳房再造
单蒂横行腹直肌肌皮瓣
Breast cancer
Breast reconstruction
Caesarotomy Unipedical transverse rectus abdominis myocutaneous flap（TRAM）
