国际医药卫生导报2025，Vol.31Issue(12)：2056-2061,6.DOI:10.3760/cma.j.cn441417-20240827-12025
顺行法分叶背阔肌皮瓣在LABC切除术后胸壁修复重建中的应用
The application of anterograde lobed latissimus dorsi flap in the reconstruction of chest wall after LABC resection
摘要
Abstract
Objective To analyze the effect of anterograde design of lobular latissimus dorsi flap in immediate reconstruction of chest wall defect after resection of locally advanced breast cancer(LABC).Methods A retrospective analysis was conducted.Fifty-nine female patients with LABC who underwent radical mastectomy for breast cancer and immediate chest wall repair and reconstruction at Xi'an International Medical Center Hospital from January 2021 to October 2023 were selected and divided into an observation group and a control group according to different methods of chest wall defect repair and reconstruction.There were 28 cases in the observation group,with an age of(53.1±6.4)years.There were 31 cases in the control group,with an age of(52.6±6.5)years.The observation group used the anterograde method to design lobulated latissimus dorsi flap for defect repair,while the control group used the pedicled rectus abdominis flap for defect repair.The perioperative related indicators(operation duration,intraoperative blood loss,number of lymph node dissections,skin defect area,postoperative drainage time,and hospital stay),complication rates,appearance satisfaction,and survival analysis indicators[overall survival rate(OS)and disease-free survival rate(DFS)]of the two groups were compared.Statistical analyses were performed using t-tests,x2 tests,Kaplan-Meier survival analysis methods and Log-Rank tests..Results The operation time and postoperative drainage time in the observation group were both shorter than those in the observation group[(231.4±30.7)min vs.(249.3±36.8)min and(4.3±0.4)d vs.(4.5±0.3)d)],and the intraoperative blood loss was lower than that in the control group[(86.9±19.5)ml vs.(98.7±24.4)ml];the differences were all statistically significant(all P＜0.05).The number of lymph node dissections in the observation group was 15.2±1.1,and the postoperative hospital stay was(8.7±0.7),while those in the control group were 14.8±1.5 and(9.1±1.2)days,respectively;there were no statistically significant differences(both P＞0.05).The total incidence of complications in the observation group was lower than that in the control group[10.7％(3/28)vs.32.3％(10/31)],and the difference was statistically significant(x2=3.975,P=0.046).After a 6-month follow-up,the proportion of very satisfied individuals in the observation group was significantly higher than that in the control group[(60.7％(17/28)vs.32.3％(10/31))],and the difference was statistically significant(P＜0.05).There was no statistical difference in the overall satisfaction between the two groups(x2=1.650,P＞0.05).The 3-year DFS rate was 71.4％(20/28)in the observation group,and 67.7％(21/31)in the control group.The OS rate was 82.1％(23/28)in the observation group,and 77.5％(24/31)in the control group.The Log-Rank test showed that there were no statistically significant differences in DFS(x2=0.142,df=1,P=0.706)and OS(x2=0.171,df=1,P=0.679)between the two groups.Conclusion The anterior-designed bilateral latissimus dorsi muscle flap for immediate chest wall reconstructions in patients with LABC can significantly optimize the surgical process(reduce operational difficulty,shorten operation time,and reduce intraoperative bleeding),while ensuring reliable blood supply to the flap and reducing complications in the donor area.The clinical efficacy is definite and worthy of promotion and application.关键词
乳腺癌/胸壁重建/分叶背阔肌皮瓣/腹部皮瓣Key words
Breast cancer/Chest wall reconstruction/Lobulated latissimus dorsi muscle flap/Abdominal flap引用本文复制引用
任杰,汪阳,席儒兴..顺行法分叶背阔肌皮瓣在LABC切除术后胸壁修复重建中的应用[J].国际医药卫生导报,2025,31(12):2056-2061,6.基金项目
陕西省科学技术厅一般项目(2022JQ-909) Shanxi Provincial Science and Technology Department General Project(2022JQ-909) （2022JQ-909）
