Latissimus Dorsi V-Y Musculocutaneous Sliding Flap for Coverage of Large Post-mastectomy Defect-A Case Report

以闊背肌V-Y前移滑動皮瓣來重建乳癌術後大面積之胸壁缺損－個案報告

張舜程(Shuen-Cheng Chang) ； 陳紹良(Shao-Liang Chen) ； 孫定平(Ding-Ping Sun) ； 陳天牧(Tim-Mo Chen) ； 王先震(Hsian-Jenn Wang)

《中華民國整形外科醫學會雜誌》 12卷3期 (2003/09) Pp. 197-204

https://doi.org/10.7096/JPSA.200309.0197

摘要

晚期乳癌經廣泛切除術後常造成前胸壁大面積缺損，而移植軟組織來覆蓋此缺損仍十分困難。闊背肌皮瓣是乳癌術後重建乳房的良好選擇。然而，它並不合適於重建大面積胸壁缺損，因爲其本身島狀表皮之形狀，會使得皮瓣之供皮區無法直接縫合而需植皮，進而造成上背部難看之疤痕。本文中之病患爲一末期左側浸潤性乳管癌患者，癌症分期爲T4N2M0。經腫瘤及乳房皮膚廣泛切除後，産生一30×20平方公分巨大面積的前胸壁缺損。我們以V-Y前移闊背肌島狀皮瓣來重建此缺損，皮瓣之供皮區可直接縫合而不需植皮。此改良皮瓣提供一個簡單而可信賴的方法，來覆蓋大面積胸壁缺損，並且使供皮區的罹病率減到最少。

並列摘要

Wide resection of advanced breast cancer usually results in extended defect of the anterior chest wall and finding an appropriate soft-tissue to close such defect is still a difficult task. The latissimus dorsi musculocutaneous flap is a good option for post-mastectomy breast reconstruction. However, it is not appropriate for covering large chest wall defect due to its conventional shape of the cutaneous island, which needs additional skin grafts for the donor site and results unsightly scar over the upper back. We reported a case of advanced infiltrating ductal carcinoma of the left breast (T4N2M0). Following wide excision of the tumor, a huge defect of the anterior chest wall, about 30×20 cm in size, was resulted. A latissimus dorsi V-Y musculocutaneous island flap was raised and slid forward to cover this defect completely with primary closure of the donor site. This modified flap provides a simple and reliable method for covering large chest wall defect and keeps the donor site morbidity at minimum.

並列關鍵字

large chest wall defect ； infiltrating ductal carcinoma of breast ； latissimus dorsi V-Y musculocutaneous island flap