Application value of different methods of segmented latissimus dorsi myocutaneous flap in repairing chest wall defect after local advanced breast cancer surgery (with video)
10.3760/cma.j.cn.115807-20220926-00260
- VernacularTitle:不同方法切取分叶背阔肌皮瓣在局部晚期乳腺癌术后胸壁缺损修复中的应用价值（附视频）
- Author:
Meiya LIU
1
;
Yongjing CHEN
;
Junjie MA
;
Zhenhua ZHAO
;
Fei LUO
;
Xinzheng LI
Author Information
1. 山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院乳腺二科，太原 030013
- Keywords:
Local late stage;
Breast cancer;
Chest wall defect;
Latissimus dorsi lobularis;
Flap repair
- From:
Chinese Journal of Endocrine Surgery
2023;17(5):550-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of different methods of segmented latissimus dorsi myocutaneous flap in repairing chest wall defects after local advanced breast cancer surgery.Methods:The clinical data of 64 patients with unilateral locally advanced breast cancer admitted to Shanxi Cancer Hospital from Feb. 2019 to Jan. 2020 were selected. All patients underwent modified radical mastectomy for breast cancer. The patients were divided into two groups according to the random number table method. Antegrade (group A, n=32 cases) and retrograde (group B, n=32 cases) were used to design and cut the segmented latissimus dorsi myocutaneous flap to repair the defects. The range of skin island cut was 14 cm×6 cm-19 cm×7 cm; The donor area of the flap was closed directly. The application effects of the two groups of methods were compared. Results:In group A, one antegrade flap was partially necrotic, while in group B, six retrograde flaps were partially necrotic ( P>0.05). The delayed healing rate of donor site incision in group A was 6.25%, significantly lower than that in group B (25.00%) ( χ2=4.267, P=0.039). All the patients in both groups were followed up for 12 to 24 months, and the appearance and texture of the flaps were satisfactory; Only linear scar was left in the donor area, and the shoulder joint activity was not affected. The mean survival time was 20.8 months. Conclusion:The antegrade latissimus dorsi myocutaneous flap can repair the large area defect of chest wall after LABC, which can ensure the blood supply of the flap to the greatest extent, reduce the closing tension of the donor area, the incidence of postoperative complications, and promote the healing of the incision.
