TRAM皮瓣乳房再造

E. Karacaoglu
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摘要

传统的乳房保守治疗(BCT)是乳房肿瘤切除术,前哨淋巴结活检和可能的腋窝清扫,以及放射治疗。众所周知,在世界范围内,BCT在总体长期生存率方面与乳房切除术在肿瘤学上是相当的。BCT是早期乳腺癌患者推荐的治疗选择。BCT的主要理念是优化美容目标和最小化乳房切除术的心理发病率,同时确保低局部复发率。实现肿瘤安全切除是由肿瘤边缘清除维持。随着肿瘤大小的增加,确保肿瘤清除需要广泛的乳腺实质切除术。这就导致了大体积切除这就需要体积置换技术。根据切除的乳房体积大小,可能需要自体组织移植来达到乳房修复的要求。背阔肌瓣和TRAM瓣是两种常用的自体组织。本章重点介绍TRAM皮瓣,这是乳房切除缺损体积置换术中最常用的自体组织之一。
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Breast Reconstruction with TRAM Flap
Traditional breast conservative therapy (BCT) is lumpectomy, sentinel lymph node biopsy and possible axillary dissection, and radiation therapy. BCT is, as known and considered all over the world, is oncologically equivalent to mastectomy with regard to overall long-term survival rates. BCT is the recommended treatment of choice for women with early stages breast cancer. The main philosophy of BCT is optimizing cosmetic goals and minimizing the psychological morbidity of a mastectomy while ensuring low rates of local recurrence. Achieving an oncologically safe resection is maintained by tumor margin clearance. Ensuring an oncologic clearance with increasing tumor size requires extensive breast parenchyma resection. And this results in large volume resection and this requires volume replacement techniques. Depending on the amount of breast volume resected, an autologous tissue transfer may be required to achieve requirement of breast restoration. Latissimus dorsi flap and TRAM flap are two autologous tissues mostly used to fulfill this restoration. This chapter focuses on the TRAM flap, one of the most commonly used autologous tissue in volume replacement reconstruction of the mastectomy defect.
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