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目的首次在国内报道迷你背阔肌脂肪瓣用于即刻乳腺癌保乳整复术,探讨该术式的肿瘤学安全性和美容效果,评价临床应用价值。方法回顾性分析本院2008年1月至2015年6月收治的18例采用迷你背阔肌脂肪瓣进行即刻乳腺癌保乳重建患者的临床病理及治疗转归资料,对肿瘤学安全性、美容效果及术后并发症进行评估。结果肿瘤直径2.8~6.5cm,中位肿瘤直径3.6cm,占乳房体积比例25%~40%。术后无明显坏死、感染、切口裂开和其他严重并发症。术后美容效果:17例(94.4%)非常满意,1例(5.6%)比较满意。随访期间患者均存活,无肿瘤复发转移。结论乳腺肿瘤即刻重建技术联合迷你背阔肌脂肪瓣是一种安全有效修复保乳术后缺损的方法,扩大了保乳手术的适应证,使患者获得更满意的美容效果。特别适合肿瘤位于外侧或上象限,术后缺损体积25%~40%的患者。
Objective To report for the first time in China on the use of mini-latsmus myocutaneous fat flap for immediate breast cancer breast-protection surgery, to discuss the safety and cosmetic effects of this surgical procedure, and to evaluate the clinical application value. Methods A retrospective analysis of the clinical pathology and treatment outcomes of 18 patients with breast cancer breast reconstruction using Mini Latissimus dorsi muscle fat liposuction from January 2008 to June 2015 was performed. The safety and beauty of oncology were studied. Efficacy and postoperative complications were assessed. Results The tumor diameter was 2.8~6.5cm, and the median tumor diameter was 3.6cm, accounting for 25%~40% of the breast volume. No necrosis, infection, incision dehiscence, and other serious complications occurred after surgery. Postoperative cosmetic results: 17 patients (94.4%) were very satisfied and 1 patient (5.6%) was satisfied. All patients survived during the follow-up period without recurrence and metastasis. Conclusion The immediate reconstruction of breast tumors combined with the mini-latsmus fat flap is a safe and effective method for repairing defects after breast conserving surgery. It expands the indications of breast-conserving surgery and enables patients to obtain more satisfactory cosmetic results. It is particularly suitable for patients with tumors in the lateral or superior quadrant and with a 25% to 40% volume defect after surgery.