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目的:研究前锯肌瓣在扩张后假体乳房再造术中的应用及其临床意义。方法:47例乳腺癌改良根治术或单纯乳腺切除患者(共47侧乳房)采用软组织扩张器并假体置入方式分期乳房再造,即扩张后假体置入乳房再造术(以下简称扩张乳房再造术),术式中均采用前锯肌瓣作为扩张器或假体外侧覆盖,观察一期及二期术后包膜挛缩、血清肿、血肿、切口裂开及感染等并发症发生情况。结果:所有观察病例中,一期扩张器置入术后(47例)无血肿发生,无感染,无切口或皮瓣坏死,2例(2侧)切口裂开;二期假体更换后(46例),无血肿发生,无感染,无切口或皮瓣坏死,无切口裂开,平均随访(465.0±2.5)d,随访期间未见包膜挛缩病例。结论:扩张后假体乳房再造术中运用前锯肌瓣能较好地固定扩张器及假体,减少并发症,防止假体移位,获得好的乳房形态。
Objective: To study the application and clinical significance of anterior serrated muscle flap in post-dilation prosthesis reconstruction. Methods: 47 cases of modified radical mastectomy or simple mastectomy (47 cases of breast) were treated with soft tissue dilator and prosthesis implantation by stage breast reconstruction, that is, the expanded prosthesis was implanted into the breast reconstruction (hereinafter referred to as the expansion of breast reconstruction Surgery), surgical procedures were used before the serratus anterior segment dilator or prosthesis cover, observe the first and second postoperative capsule contracture, seroma, hematoma, incision rupture and infection and other complications. RESULTS: In all the cases observed, no hematoma occurred, no infection, no incision or skin flap necrosis occurred in the first stage of dilator placement (47 cases), and 2 cases (2 sides) 46 cases), no hematoma occurred, no infection, no incision or necrosis of the flap, no incision rupture, the average follow-up (465.0 ± 2.5) d, no cases of capsular contracture during follow-up. CONCLUSIONS: The use of anterior serrated muscle flap in the post-expansion prosthesis reconstruction can better fix the dilator and prosthesis, reduce the complications, prevent the prosthesis from shifting, and obtain a good breast shape.