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目的 减轻乳癌根治术及放疗后上肢淋巴水肿。方法 采用带蒂背阔肌肌皮瓣移转一期完成治疗乳癌根治术加根治量放疗后所致上肢严重淋巴水肿伴胸壁放射性溃疡、上肢上举受限 12例。结果 肌皮瓣成活良好 ,上肢淋巴水肿明显减轻 (消肿率达 5 1%～ 67% ) ,上举功能明显改善 (达 10 0～ 110度 ) ,随访 1～ 3年未见复发。结论 本手术简单、省时、安全、有效 ,不仅能减轻肢体淋巴水肿 ,还可修复胸壁塌陷畸形 ,解除腋部瘢痕牵扯 ,改善上肢上举功能 ,因此 ,不失为一种可行的治疗乳癌根治术后继发上肢淋巴水肿的方法。
Objective To reduce upper limb lymphedema after radical mastectomy and radiotherapy. Methods The pedicled latissimus dorsi myocutaneous flap was transferred in one phase to complete the treatment of radical mastectomy plus radical radiotherapy. The severe upper limb lymphedema associated with chest wall radioactive ulceration and upper limb restriction were found in 12 patients. Results The myocutaneous flaps survived well. The lymphedema in the upper limbs was significantly reduced (the swelling rate was 5 to 67%), and the lifting function was significantly improved (up to 100 to 110 degrees). No recurrence was observed in the follow-up of 1 to 3 years. Conclusion This operation is simple, time-saving, safe and effective. It can not only reduce limb lymphedema, but also repair chest wall collapse malformation, relieve the involvement of ankle scars, and improve the upper extremity lifting function. Therefore, it is a feasible treatment for breast cancer after radical surgery. Secondary upper limb lymphedema.