Pedicled latissimus dorsi flap for breast reconstruction

史京萍

doi:10.19401/j.cnki.1007-3639.2017.08.003

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Pedicled latissimus dorsi flap for breast reconstruction

更新时间：2025-12-31

- Pedicled latissimus dorsi flap for breast reconstruction
- China Oncology Vol. 27, Issue 8, Pages: 613-619(2017)
- 作者机构：
  
  南京医科大学第一附属医院整形烧伤科,江苏,南京,210029
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2017.08.003
  CLC：
- Published Online：21 September 2017，
  
  Published：21 September 2017
- 稿件说明：
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史京萍. 带蒂背阔肌皮瓣在乳房重建手术中的应用[J]. 中国癌症杂志, 2017, 27(8): 613-619.

史京萍. Pedicled latissimus dorsi flap for breast reconstruction[J]. China Oncology, 2017, 27(8): 613-619.
史京萍. 带蒂背阔肌皮瓣在乳房重建手术中的应用[J]. 中国癌症杂志, 2017, 27(8): 613-619. DOI： 10.19401/j.cnki.1007-3639.2017.08.003.

史京萍. Pedicled latissimus dorsi flap for breast reconstruction[J]. China Oncology, 2017, 27(8): 613-619. DOI： 10.19401/j.cnki.1007-3639.2017.08.003.

摘要

随着乳腺癌治疗模式的发展及患者观念的转变，乳房重建逐渐成为乳腺癌治疗的一部分。背阔肌因面积较大，且蒂部解剖变异较少，同时血供丰富可被改良成不同的皮瓣，因此被认为是良好的供瓣区。在乳房重建中，背阔肌肌皮瓣的应用较广，不仅可以使用全背阔肌或联合假体进行乳房重建，且可以根据不同的缺损范围选择合适的背阔肌皮瓣进行乳房缺损的修补。相比单纯植入物重建，背阔肌皮瓣可获得更为良好的乳房形态且对术后放疗影响较小；相比下腹部皮瓣，背阔肌皮瓣瘢痕较短，术后恢复较快。目前对于术后供区缝合方式的改进及辅助药物的应用，极大地降低了血清肿的发生率；腔镜技术的应用也避免了切取背阔肌皮瓣遗留的供区瘢痕。在临床应用中，背阔肌皮瓣行乳房重建患者满意率高，术后审美效果良好，是乳房重建中一种较为优势的手术方法。该研究总结了背阔肌皮瓣行乳房重建对并发症的控制并对近年来的手术中的问题作进一步探讨。

Abstract

With the development of breast cancer treatment mode and the changing attitudes of patients

reconstruction of the breast after mastectomy plays an important role in the interdisciplinary treatment concept of breast cancer. Because of the large area and the less variation of vessels pedicle of latissimus dorsi

it is considered to be an alternative flap for breast reconstruction. The latissimus dorsi flap can be used widely in breast reconstruction. Besides the implant-assisted latissimus dorsi (LDI) and autologous latissimus dorsi (ALD) flap breast reconstructions

the modified latissimus dorsi flap could be selected for various mastectomy. Compared with implant-assisted breast reconstruction

the latissimus dorsi flap can model a better mammary contour and receive better cosmetic outcomes on post-reconstruc- tion radiation. Compared with the transverse rectus abdominis myocutaneous (TRAM) flap

the latissimus dorsi flap has smaller scars and more rapid recovery. The improvement in postoperative donor area suturing techniques and auxiliary drug application greatly reduced the incidence of seroma. The Endoscopic technology avoids the donor scar. In clinical practice

statistical evaluation of aesthetic outcomes was impossible as an advantage in operation selection. This article summarized the control of complications and the further discussion of controversy.

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