留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

双侧腹壁浅动脉穿支皮瓣移植再造1例单侧乳腺癌患者乳房

宋达疆 李赞 周晓 章一新 周波 吕春柳 唐园园 易亮 罗振华

宋达疆, 李赞, 周晓, 等. 双侧腹壁浅动脉穿支皮瓣移植再造1例单侧乳腺癌患者乳房[J]. 中华烧伤与创面修复杂志, 2022, 38(10): 964-967. DOI: 10.3760/cma.j.cn501225-20220306-00047.
引用本文: 宋达疆, 李赞, 周晓, 等. 双侧腹壁浅动脉穿支皮瓣移植再造1例单侧乳腺癌患者乳房[J]. 中华烧伤与创面修复杂志, 2022, 38(10): 964-967. DOI: 10.3760/cma.j.cn501225-20220306-00047.
Song DJ,Li Z,Zhou X,et al.Transplantation of bilateral superficial inferior epigastric artery perforator flap for breast reconstruction in a patient with unilateral breast cancer[J].Chin J Burns Wounds,2022,38(10):964-967.DOI: 10.3760/cma.j.cn501225-20220306-00047.
Citation: Song DJ,Li Z,Zhou X,et al.Transplantation of bilateral superficial inferior epigastric artery perforator flap for breast reconstruction in a patient with unilateral breast cancer[J].Chin J Burns Wounds,2022,38(10):964-967.DOI: 10.3760/cma.j.cn501225-20220306-00047.

双侧腹壁浅动脉穿支皮瓣移植再造1例单侧乳腺癌患者乳房

doi: 10.3760/cma.j.cn501225-20220306-00047
基金项目: 

湖南省卫生健康委科研课题项目 B2019092, 20201650, 20200829

湖南省自然科学基金科卫联合项目 2018JJ6028

长沙市科技计划基础研究项目 kq1901074, kq1901077

详细信息
    通讯作者:

    李赞,Email:zzanli@163.com

Transplantation of bilateral superficial inferior epigastric artery perforator flap for breast reconstruction in a patient with unilateral breast cancer

Funds: 

Hunan Provincial Health and Family Planning Commission Project B2019092, 20201650, 20200829

Science and Health Planning Project of Hunan Provincial Natural Science Foundation 2018JJ6028

Basic Research Project of Science and Technology Plan of Changsha City kq1901074, kq1901077

More Information
  • 摘要: 2020年5月14日,湖南省肿瘤医院收治1例37岁女性单侧乳腺癌患者,对其行右侧乳腺癌改良根治+双侧腹壁浅动脉穿支皮瓣(重量为305 g)游离移植再造乳房。术中将右侧腹壁下血管蒂与右侧胸廓内血管近端吻合、左侧腹壁下血管蒂与右侧胸廓内血管远端吻合,见皮瓣通血良好,将腹部皮瓣供区创面直接拉拢闭合。手术历时9 h。术后第1个48 h皮瓣显示轻度灌大于流,未见明显水肿或水疱,皮瓣温度与周围皮肤一致,引流管引流量仅40 mL。术后3 d皮瓣血运完全恢复正常,皮瓣存活良好,供区切口无明显张力,愈合顺利。随访2个月,腹部供区切口完全愈合,仅遗留线性瘢痕,重建乳房外形自然,患者计划进一步行乳头重建和对侧乳房悬吊术。该病例提示在特定情况下可选用双侧腹壁浅动脉穿支皮瓣进行自体乳房再造,以最大限度减少供区损伤。

     

  • 1  双侧腹壁浅动脉穿支皮瓣游离移植再造1例右侧乳腺癌患者乳房。1A.手术设计;1B.显露并长段分离双侧腹壁浅动静脉;1C.夹闭腹壁下动脉穿支血管证明皮瓣血运良好;1D.下腹部前鞘保留完整;1E.皮瓣制备完毕;1F.术中将右侧腹壁下血管蒂与右侧胸廓内血管近端吻合、左侧腹壁下血管蒂与右侧胸廓内血管远端吻合;1G.术后即刻观,皮瓣通血良好;1H.术后2个月,受区外观良好

  • [1] GrottingJC.The free abdominoplasty flap for immediate breast reconstruction[J].Ann Plast Surg,1991,27(4):351-354.DOI: 10.1097/00000637-199110000-00011.
    [2] HamdiM,KhuthailaDK,Van LanduytK,et al.Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction: new horizons in microsurgical tissue transfer to the breast[J].J Plast Reconstr Aesthet Surg,2007,60(8):904-912; discussion 913-914.DOI: 10.1016/j.bjps.2007.02.016.
    [3] ParkJE,ShenaqDS,SilvaAK,et al.Breast reconstruction with SIEA flaps: a single-institution experience with 145 free flaps[J].Plast Reconstr Surg,2016,137(6):1682-1689.DOI: 10.1097/PRS.0000000000002158.
    [4] CoroneosCJ,HellerAM,VoineskosSH,et al.SIEA versus DIEP arterial complications: a cohort study[J].Plast Reconstr Surg,2015,135(5):802e-807e.DOI: 10.1097/PRS.0000000000001150.
    [5] TaylorGI,DanielRK.The anatomy of several free flap donor sites[J].Plast Reconstr Surg,1975,56(3):243-253.DOI: 10.1097/00006534-197509000-00001.
    [6] SternHS,NahaiF.The versatile superficial inferior epigastric artery free flap[J].Br J Plast Surg,1992,45(4):270-274.DOI: 10.1016/0007-1226(92)90050-8.
    [7] ChevrayPM.Breast reconstruction with superficial inferior epigastric artery flaps: a prospective comparison with TRAM and DIEP flaps[J].Plast Reconstr Surg,2004,114(5):1077-1083; discussion 1084-1085.DOI: 10.1097/01.prs.0000135328.88101.53.
    [8] ArnezZM,ScampT.The bipedicled free TRAM flap[J].Br J Plast Surg,1992,45(3):214-218.DOI: 10.1016/0007-1226(92)90080-h.
    [9] XuH,DongJ,WangT.Bipedicle deep inferior epigastric perforator flap for unilateral breast reconstruction: seven years' experience[J].Plast Reconstr Surg,2009,124(6):1797-1807.DOI: 10.1097/PRS.0b013e3181bf81cf.
    [10] AgarwalJP,GottliebLJ.Double pedicle deep inferior epigastric perforator/muscle-sparing TRAM flaps for unilateral breast reconstruction[J].Ann Plast Surg,2007,58(4):359-363.DOI: 10.1097/01.sap.0000239818.28900.81.
    [11] RabeyNG,ErelE,MalataCM.Double-pedicled abdominal free flap using an entirely new microvascular combination of DIEP and SIEA vascular pedicles for unilateral breast reconstruction: a novel addition to the Hamdi classification[J].Plast Reconstr Surg,2012,130(5):767e-769e.DOI: 10.1097/PRS.0b013e318267d995.
    [12] MohanAT,PatelNG,MalataCM.Combination of the superior and inferior pedicle "continuities" for anastomosis of an SIEA flap to a contralateral DIEP flap in double-pedicled abdominal free flaps: a further modification of the Hamdi classification[J].J Plast Reconstr Aesthet Surg,2014,67(10):e237-239.DOI: 10.1016/j.bjps.2014.06.008.
    [13] 宋达疆,李赞,周晓,等.胸壁肿瘤术后胸壁复杂缺损修复重建策略[J].中华胸心血管外科杂志,2017,33(3):164-167.DOI: 10.3760/cma.j.issn.1001-4497.2017.03.011.
    [14] 宋达疆,李赞,周晓,等.不同形式横行腹直肌肌皮瓣在乳房再造和胸壁溃疡修复中的应用经验教训及对策[J].中国医师杂志,2018,20(4):511-516.DOI: 10.3760/cma.j.issn.1008-1372.2018.04.009.
    [15] 宋达疆,彭文,李赞,等.携带髂腹股沟淋巴组织瓣的游离腹壁下动脉穿支皮瓣治疗乳腺癌根治术后并发上肢淋巴水肿并再造乳房的临床效果[J].中华烧伤杂志,2019,35(4):277-283.DOI: 10.3760/cma.j.issn.1009-2587.2019.04.007.
    [16] SongD,LiuD,PafitanisG,et al.Extensive microsurgical reconstruction of chest wall defects for locally advanced breast cancer: a 10-year single-unit experience[J].Ann Plast Surg,2020,84(3):293-299.DOI: 10.1097/SAP.0000000000002000.
    [17] 宋达疆,刘德权,李赞,等.游离腹壁下动脉穿支皮瓣在双侧乳房再造中的应用[J].中华整形外科杂志,2019,35(9):892-897.DOI: 10.3760/cma.j.issn.1009-4598.2019.09.009.
    [18] 宋达疆,李赞,周晓,等.局部晚期乳腺癌切除术后巨大复杂创面的整形外科修复[J].中华整形外科杂志,2018,34(8):630-635.DOI: 10.3760/cma.j.issn.1009-4598.2018.08.011.
    [19] 李赞,宋达疆.肿瘤性复杂性胸壁缺损的修复策略及对肿瘤治疗的积极影响[J].中华整形外科杂志,2020,36(3):231-241.DOI: 10.3760/cma.j.cn114453-20200301-00091.
    [20] 宋达疆,李赞,章一新,等.带蒂腹直肌肌皮瓣联合游离腹壁下动脉穿支皮瓣及携带髂腹股沟淋巴组织瓣行乳腺癌根治术后乳房再造及上肢淋巴水肿治疗的效果[J].中华烧伤杂志,2020,36(4):297-303.DOI: 10.3760/cma.j.cn501120-20190117-00011.
  • 加载中
图(1)
计量
  • 文章访问数:  173
  • HTML全文浏览量:  38
  • PDF下载量:  28
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-03-06
  • 网络出版日期:  2022-10-24

目录

    /

    返回文章
    返回