DIEP皮瓣与背阔肌肌皮瓣再造一侧乳房时对侧乳房处理比较.doc

DIEP皮瓣与背阔肌肌皮瓣再造一侧乳房时对侧乳房处理比较 　　[摘要]目的:探讨DIEP(腹壁下动脉穿支,deep inferior epigastic perforator,简称DIEP)皮瓣与背阔肌肌皮瓣再造一侧乳房时对侧乳房处理策略的比较。方法:2006年7月至2009年10月,选取15例保留乳头乳晕的乳癌改良根治术和10例Poland综合征的患者,其中12例行一侧DIEP皮瓣再造,余13例行一期背阔肌肌皮瓣转移并植入扩张器,术前对侧乳房下垂,3～5个月后二期乳房行假体置换扩张器,如双侧乳房不对称,同时进行对侧乳房的乳房缩小处理,期望能达到两侧对称性。结果:10例DIEP再造的乳房与对侧基本对称,另外2例要求二期修整。13例背阔肌肌皮瓣要求处理对侧下垂乳房,经处理后,与DIEP再造乳房相比,对称性仍感不足。 结论:与DIEP乳房再造相比,背阔肌肌皮瓣乳房再造之后为了达到两侧乳房对称,处理对侧乳房是必要的。 　　[关键词]DIEP;背阔肌;乳房再造;单侧;对侧;皮瓣 　　[中图分类号]R655.8 [文献标识码]A[文章编号]1008-6455(2010)06-0810-03 　　 　　To explore contrast in contralateral breast management when unilateral breast was reconstructed between DIEP flap and lattisimus dorse muscle 　　CHEN Bao-guo,QIAO Qun,HUANG Wei-qing,ZHANG Hai-lin,ZHU Lin 　　(Department of Plastic Surgery,Peking Union Medical College Hospital,Peking Union Medical College,Beijing 100032,China) 　　 　　Abstract:ObjectiveTo explore contrast in contralateral breast management when unilateral breast was reconstructed between DIEP(deep inferior epigasric perferators) flap and lattisimus dorse muscle flap. MethodsFrom Jul.2006 to Oct.2009,15 cases with modified radical mastectomy and 10 cases with Polands syndrome were choosed.In between,12 cases undergone DIEP transplantation for unilateral breast reconstruction.The remaining 13 cases received lattisimus dorse muscle shift and expander implantation. Contralateral breast drooped preoperatively.After 3 to 5 months,the expander was replaced with implant.If bilateral breasts had no symmetry, the drooped breast was treated with reduction procedure,which is expected to realize symmetry.Results10 cases with DIEP breast reconstruction had general symmetrical with the contralateral breast,when another 2 cases requested secondary modification.All 13 cases with lattisimus dorse muscle breast reconstruction had requested operation for the contralateral breast management.Even with modification,the symmetry did not meet our expectation when it was compared to DIEP performance.Conclusions Compared to DIEP