前肋间动脉穿支皮瓣作为部分乳房重建的简单技术:我们机构的初步经验

R. Amira Maher, A. Osman, K. Fahmy, Nouf M. Ebied, Reda A. Eissa
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摘要

背景:肿瘤整形手术为保乳手术带来了新的维度,并将乳房手术的美学原则添加到乳腺癌的治疗中。近年来出现了许多无明显供区并发症的体积替代技术,肋间动脉前穿支皮瓣是中小乳房下极肿瘤部分乳房再造术的理想选择。目的:本研究的目的是报告我们在部分乳房重建方法中使用前肋间穿支皮瓣的临床经验:2018年4月至2019年6月,我们在艾因沙姆斯大学医院对25例中小型乳房下极肿瘤患者进行了选择,其他选择如mMDTmoplasty对他们不利。结果:艾因沙姆斯大学医院多学科团队选择25例患者行肋间动脉穿支皮瓣部分乳房再造术。患者平均年龄45.68岁,平均体重指数32.32。皮瓣平均手术时间64分钟,住院时间1 ~ 2天,局部复发随访6 ~ 14个月。伤口并发症1例(4%)。美容结果由MDT评定,评分为1-5分,1分为最差美容结果,5分为最佳美容结果,评分为5分的占76%,评分为4分的占14%,评分为3分的占8%。根据病人满意度分数从1到5是用于分数1最小满意分数5代表最满意的水平,有80%的病人给分数5,12%的情况下给分数4和8%的情况下给分数3结论:根据我们的经验,部分使用AICAP皮瓣乳房重建是一个可靠的选择降低乳腺肿瘤在中小型的乳房大小和完美的化妆品结果和并发症率可以忽略不计。
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Anterior Intercostal Artery Perforator Flap as a Simple Technique for Partial Breast Reconstruction: Our Institutional Initial Experience
Background: The oncoplastic surgery has brought new dimensions to breast conserving surgery and added the aesthetic principles of breast surgery to breast cancer management. Recently there's a lot of volume replacement techniques without significant donor site morbidity .The anterior intercostal artery perforator (AICAP) flap is a suitable option in partial breast reconstruction for lower pole tumors in small and medium sized breasts. Objectives: The aim of this study is to report our clinical experience with anterior intercostal perforator flap in partial breast reconstruction Methodology: 25 cases were performed between April 2018 to June 2019 at in Ain shams university hospitals for selected patients with lower breast pole tumors with small and medium sized breast and other option like reduction mMDTmoplasty wasn't favorable for them. Results: A total of 25 patient were selected by the multidisplinary team at Ain shams university hospital for partial breast reconstruction with anterior intercostal artery perforator flap . The mean age of the cases was 45.68 with mean body mass index of 32.32. The mean operative time for the flap was 64 minutes while the hospital stay was ranging from 1-2 days .Follow-up for local recurrence was from 6 to 14 months. There was 1 case with wound complication (4%). The cosmetic outcome was assessed by the MDT and a giving score from 1-5 was used with 1 is the least favorable cosmetic outcome and 5 is the best result 76% of the cases scored 5, 14% scored 4, 8% scored 3. According to patient satisfaction a score from 1 to 5 was used with the score 1 is least satisfied and score 5 represents the most satisfaction level, there was 80% of the patient gave the score 5, 12% of the cases gave the score 4 and 8% of the cases gave the score 3 Conclusions: Based on our experience, partial breast reconstruction using AICAP flap is a reliable option for lower breast tumors in small-to-moderate breast size with perfect cosmetic outcome and negligible rate of complication.
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