The Simultaneous Combination of lmplants and Tram Flaps for an Aesthetically Pleasing Breast

利用橫向腹直肌肌皮瓣以及人工義乳的合併運用來重建乳房

張高評(Kao-Ping Chang) ； 林幸道(Sin-Daw Lin) ； 林才民(Tsai-Ming Lin) ； 蔡志成(Chih-Cheng Tsai) ； 賴春生(Cheng-Sheng Lai)

《The Kaohsiung Journal of Medical Sciences》 18卷5期 (2002/05) Pp. 215-220

https://doi.org/10.6452/KJMS.200205.0215

摘要

利用橫向腹直肌肌皮瓣重建乳房手術一直是乳癌切除後的首選術式。但在台灣，多數乳癌患者的腹部組織比起其本身乳房組織要大許多。除此之外，另外有部分的乳癌患者，其腹部皮瓣的組織與乳房體積都不足以塑造一對美感的乳房；在此情況之下，吾人建議在術中，同時在對側或兩側植入一個義乳來取得均衡美感。高雄醫學大學在1997年2月到2000年3月，完成了250例乳房重建手術，其中有10位患者接受術中同時植入義乳的建議。這10位患者並沒有任何併發症，其中尚有9位相當滿意此種作法，有8位會將此種術式推薦給其他病友。所以利用橫向腹直肌肌皮瓣與人工義乳的合併運用，能夠提供乳癌患者一個更趨於美感的乳房重建。

並列摘要

In Taiwan, there have quite often been incidences when patients have had more abundant abdominal tissue to make a TRAM flap with a volume larger than the contralateral breast. In these situations, we usually recommend performing contralateral augmentation mammoplasty with a saline implant while undergoing TRAM flap reconstruction. From February 1997 to Mar 2001, 250 breast cancer patients underwent immediate pedicled TRAM flap reconstructions at Kaohsiung Medical University Hospital. Of these, 10 cases not only had TRAM flaps, but also simultaneous insertion of a prosthesis into the contralateral/bilateral breast to form a more pleasing breast mound. These were all saline implants. Each patient was young (aged 31-51 years) and had small to medium sized breasts. During the procedure, the implants were placed in a submuscular pocket formed by the pectoralis major muscle. There were no significant complications or failures. All breasts have remained soft and naturallooking during the follow-up period. Nine of 10 patients appreciated this procedure, and 8 of them would agree to convince other patients of the benefits of this operation. Using pedicled TRAM flaps and saline breast implants can achieve immediate breast reconstruction without the need for prolonged tissue expansion or an obvious back scar. Aesthetic results are excellent and the immediate use of an implant does Dot appear to pose a risk to the success of the pedicle transfer. It is a good alternative for breast cancer patients with previous hypoplasia of the breasts to achieve simultaneous therapeutic and cosmetic results.

並列關鍵字

TRAM flap ； breast implants