组织工程与重建外科杂志2024，Vol.20Issue(4)：428-433,6.DOI:10.3969/j.issn.1673-0364.2024.04.006
分叶游离下腹部皮瓣移植乳房再造的血管吻合方式选择
Selection of vascular anastomosis methods for breast reconstruction using lobed free lower abdominal flap transplantation
摘要
Abstract
Objective To summarize the indications and vascular anastomosis methods selection for the transplantation of lobed free lower abdominal flap for breast reconstruction.Methods From October 2019 to June 2023,17 female breast cancer patients received lobulated free lower abdominal flap transfer for breast reconstruction,including 10 cases of immediate breast reconstruction and 7 cases of delayed breast reconstruction.All the cases were completed by transplantation of lobulated free lower abdominal flaps,including 20 M1 type free rectus abdominis skin flaps,6 M2 types,and 8 M3 types.The specific vascular anastomosis methods include supercharge in 9 cases and turbocharge in 8 cases.The recipient vessels include 14 sides of the proximal end of the internal mammary vessels,10 sides of the main trunk of the thoracodorsal vessels,3 sides of the serratus anterior branches,2 cases of the lateral thoracic artery and vein,and 5 sides of the distal end of the internal mammary vessels.Results Each side flap had a length of(14.2±0.4)cm,a width of(11.5±1.0)cm,and a thickness of(4.9±0.3)cm.All flaps had good blood circulation and all survived smoothly.All patients were followed up for 6 to 38 months(20.7 months on average),no recurrence was noted.The reconstructed breasts had good appearance,satisfactory texture,no flap contracture and deformation,and was basically symmetrical with the healthy breast.The flap donor site and breast recipient area only had linear scars left,and there was no significant impact on abdominal wall function.Conclusion The lobed free lower abdominal flap is suitable for breast reconstruction with large base and sagging convexity.Choosing a reasonable vascular anastomosis method can ensure the free placement of the flap and satisfactory breast shaping.关键词
分叶皮瓣/游离腹直肌皮瓣/乳房再造/乳腺癌Key words
Lobed flap/Free rectus abdominis flap/Breast reconstruction/Breast cancer分类
医药卫生引用本文复制引用
宋达疆,张天怡,王志远,刘旭,李赞,章一新..分叶游离下腹部皮瓣移植乳房再造的血管吻合方式选择[J].组织工程与重建外科杂志,2024,20(4):428-433,6.基金项目
湖南省卫生健康委科研计划课题(202209024847). （202209024847）
