Breast Reconstruction after Mastectomy with DIEP Flap

用深下腹壁動脈穿通皮瓣作乳房切除後重建

龔正良(Jenq-Liang Kung) ； 吳瑞星(Simon Jui-Hsing Wu) ； 呂旭彥(Shiuh-Yen Lu) ； 陳明庭(Ming-Ting Chen)

《中華民國整形外科醫學會雜誌》 10卷3期 (2001/09) Pp. 151-158

https://doi.org/10.7096/JPSA.200109.0003

摘要

在過去十年來，橫向腹直肌肌皮瓣已經成為乳房切除後自體乳房重建的選擇手術。雖然它有很多好處，但是，腹壁的併發症一直是重建乳房的整形外科醫師所顧慮的。自從1994年Allen和Treece成功地利用深下腹壁動脈穿通皮瓣來重建乳房，近年來已經有越來越多人使用它了。報告指出，雖然它可能有較高比率的部分皮瓣損失和脂肪壞死，但是其結果是可以媲美橫向腹直肌肌皮瓣的。
在熟悉了橫向腹直肌肌皮瓣後，我們選擇了深下腹壁動脈穿通皮瓣來重建最近十個病人。我們認為它是一個重建乳房不錯的方法。

並列摘要

The transverse rectus abdominis musculocutaneous (TRAM) flap has become the procedure of choice for autologous breast reconstruction after mastectomy in the past decade. Despite the numerous advantages of the free TRAM flap, abdominal wall complications are the major concerns for plastic surgeons performing breast reconstruction with TRAM flaps. Since the report of successful breast reconstruction with the free deep inferior epigastric perforator (DIEP) flap by Allen and Treece in 1994, there has been increasing use of the free DIEP flap for breast reconstruction in recent years. The reported results of the free DIEP flaps were comparable to those of the free TRAM flaps, though there might be slightly increases of rates of partial flap loss and fat necrosis. However, the abdominal wall complications could be eliminated.
After the experiences of breast reconstructions with free TRAM flaps, we chose the free DIEP flap as our procedure for the breast reconstruction after mastectomy for recent 10 cases. There was no total or partial flap loss. The results were cosmetically acceptable, though the dissections of perforators were tedious. We believe the free DIEP flap is an excellent technique that can obtain a successful, autologous tissue breast reconstruction with minimal donor-site morbidity.

並列關鍵字

DIEP flap ； deep inferior epigastric perforator flap ； post-mastectomy breast reconstruction