首页|期刊导航|实用医学杂志|胸外侧动脉穿支皮瓣与部分背阔肌皮瓣在保乳整形中的应用

胸外侧动脉穿支皮瓣与部分背阔肌皮瓣在保乳整形中的应用OA

Comparison of lateral thoracic artery perforator flap and partial latissimus dorsi myocutaneous flap in breast-conserving reconstruction

中文摘要英文摘要

目的 比较部分背阔肌(partial latissimus dorsi musculocutaneous,pLD-MC)皮瓣与胸外侧动脉穿支皮瓣(lateral thoracic artery perforator,LTAP)在容积替代保乳手术中的临床应用效果.方法 本研究纳入2020年7月至2024年7月于广西医科大学附属肿瘤医院乳腺外科接受容积替代保乳手术的患者共49例,根据所采用的皮瓣类型分为LTAP组(n=29)和pLD-MC组(n=20).比较两组术后并发症发生率、手术时间、BREAST-Q评分,并采用Log-rank检验进行无病生存期(disease-free survival,DFS)和总生存期(overall survival,OS)分析.结果 LTAP组手术时间显著短于pLD-MC组(P<0.05).术后BREAST-Q评分显示,LTAP组在躯体健康评分及手术效果评价评分方面均高于pLD-MC组(P<0.05).LTAP组并发症发生率为3.4%(1/29),pLD-MC组为10.0%(2/20),两组间差异无统计学意义(P>0.05).DFS及OS分析显示,两组间差异无统计学意义(P>0.05).结论 在肿瘤位于乳房外象限、LTAP解剖可见且侧胸壁可提供足够组织量的前提下,LTAP皮瓣相较于pLD-MC皮瓣手术时间更短,术后躯体健康评分更优,且安全性相当,可作为优先选择的容积替代保乳方式.

Objective To compare the clinical outcomes of the partial latissimus dorsi musculocutaneous(pLD-MC)flap and the lateral thoracic artery perforator(LTAP)flap in volume replacement breast-conserving sur-gery.Methods A total of 49 patients who underwent volume replacement breast-conserving surgery in the Depart-ment of Breast Surgery at the Affiliated Tumor Hospital of Guangxi Medical University between July 2020 and July 2024 were included in this study.Based on the type of flap used,the patients were divided into an LTAP group(n=29)and a pLD-MC group(n=20).Postoperative complication rates,operative time,and BREAST-Q scores were compared between the two groups.Disease-free survival(DFS)and overall survival(OS)was analyzed using the Log-rank test.Results The operative time in the LTAP group was significantly shorter than that in the pLD-MC group(P<0.05).Postoperative BREAST-Q scores showed that the LTAP group achieved significantly higher scores in physical well-being and satisfaction with surgical outcomes compared to the pLD-MC group(P<0.05).The complication rate was 3.4%(1/29)in the LTAP group and 10.0%(2/20)in the pLD-MC group,with no sta-tistically significant difference between the two groups(P>0.05).Analysis of DFS and OS also revealed no statis-tically significant differences between the groups(P>0.05).Conclusion For tumors located in the outer quad-rant of the breast,when the lateral thoracic artery perforator is anatomically identifiable and the lateral chest wall can provide sufficient tissue volume,the LTAP flap is associated with a shorter operative time and superior physi-cal well-being scores postoperatively,while maintaining comparable safety profiles to the pLD-MC flap.Therefore,the LTAP flap may be considered the preferred option for volume replacement in breast-conserving surgery.

练斌;黄彦琳;黄诗婷;谭晓玲;何绮雯;欧阳燕;黄真;覃庆洪

广西医科大学附属肿瘤医院乳腺外科(广西南宁 530021)广西医科大学肿瘤医学院(广西南宁 530021)广西医科大学肿瘤医学院(广西南宁 530021)广西医科大学肿瘤医学院(广西南宁 530021)广西医科大学肿瘤医学院(广西南宁 530021)广西医科大学肿瘤医学院(广西南宁 530021)广西医科大学附属肿瘤医院乳腺外科(广西南宁 530021)广西医科大学附属肿瘤医院乳腺外科(广西南宁 530021)

医药卫生

乳腺癌保乳整形术胸外侧动脉穿支皮瓣部分背阔肌皮瓣BREAST-Q

breast cancerbreast-conserving plastic surgerylateral thoracic artery perforator flappartial latissimus dorsi flapBREAST-Q

《实用医学杂志》 2026 (9)

1517-1524,8

广西壮族自治区卫生健康委员会自筹课题项目(编号:Z20210117)广西中青年教师基础能力提升项目(编号:2025KY0124)大学生创业创新训练计划项目(编号:X202410598380,X202410598383,X202510598250)广西高校乳腺癌诊治研究重点实验室

10.3969/j.issn.1006-5725.2026.09.005

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