Clinical effects of free deep inferior epigastric perforator flap carrying lymphatic groin flap for treatment of upper limb lymphedema after radical mastectomy and breast reconstruction
10.3760/cma.j.issn.1009-2587.2019.04.007
- VernacularTitle: 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
- Author:
Dajiang SONG
1
;
Wen PENG
1
;
Zan LI
1
;
Xiao ZHOU
1
;
Yixin ZHANG
2
;
Guang FENG
3
;
Xiaowei PENG
1
;
Bo ZHOU
1
;
Chunliu LYU
1
;
Yan OU
1
;
Huangxing MAO
1
;
Zeyang LIU
1
;
Hui LI
1
Author Information
1. Department of Oncology Plastic Surgery, Hunan Cancer Hospital, Changsha 410008, China
2. Department of Plastic and Reconstructive Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
3. Wound Repair Center, Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Surgical flaps;
Mammaplasty;
Lymphedema
- From:
Chinese Journal of Burns
2019;35(4):277-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effects of free deep inferior epigastric perforator flap carrying lymphatic groin flap for treatment of upper limb lymphedema after radical mastectomy and breast reconstruction.
Methods:From October 2014 to December 2016, 10 female patients, aged 37-60 (48±8) years, who had lymphedema in the upper limb after radical mastectomy, were admitted to Department of Oncology Plastic Surgery of Hunan Cancer Hospital. Three patients suffered recurrent erysipelas infections, and 4 patients suffered consistent neuropathic pain in the upper limb. Free deep inferior epigastric perforator flap carrying lymphatic groin flap was used for breast reconstruction and lymphedema treatment. Operation was performed by 2 surgeon groups including recipient site prepare group and flap harvest group. In the 10 patients, the length of the flaps was (26.2±0.3) cm, the width of the flaps was (13.4±0.4) cm, and the thickness of the flaps was (3.4±0.3) cm. All the donor sites in the abdomen were closed directly. The choices of vascular pedicles and vessels in the recipient sites, operation time, complications, operation effects, and follow-up were recorded.
Results:(1) Bilateral vascular pedicle was adopted in flaps of 5 patients. Unilateral vascular pedicle was adopted in flaps of 5 patients. The recipient vessels were proximal and distal ends of internal thoracic vessels in 4 cases, the proximal end of thoracodorsal vessels in 3 cases, the proximal end of internal thoracic vessels in 2 cases, and the proximal end of internal thoracic vessels and thoracodorsal vessels in 1 case. (2) The operation time of the patients was 330-480 (406±55) min. (3) Subcutaneous edema was observed in flaps of 2 patients and donor site of 1 patient, which were all healed by dressing change therapy. The other flaps survived successfully. The reconstructed breasts were in good shape and elasticity. Nine patients had different degrees of relief in lymphedema in the upper limb. All 10 patients were followed up for 6 to 28 months, no one had recurrent erysipelas infections, and neuropathic pain in the upper limb was relieved in 2 patients. Only linear scar was left in the donor sites of 10 patients, and the function of abdomen was not affected without related complications.
Conclusions:Free deep inferior epigastric perforator flap carrying lymphatic groin flap can simultaneously accomplish breast reconstruction and upper limb lymphedema treatment, which is worthwhile to be popularized in clinic.
