[Application of pedicled omentum flap in breast reconstruction of breast cancer patients]

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug 15;33(8):1006-1010. doi: 10.7507/1002-1892.201901007.
[Article in Chinese]

Abstract

Objective: To explore the clinical application of the pedicled omentum flap in breast reconstruction of breast cancer patients.

Methods: Between May 2013 and October 2017, 205 patients with breast cancer received modified mastectomy. The pedicled omentum flap was used to reconstruct breast at the same time. All patients were female with an average age of 34.9 years (mean, 26-58 years). The tumor located at left breast in 127 cases and right side in 78 cases. The diameter of the tumor was 2-5 cm (mean, 2.9 cm). The 120 cases of breast cancer were at stage Ⅰ and 85 cases were at stage Ⅱ; and 126 cases were invasive ductal carcinoma and 79 cases were invasive lobular carcinoma. The course of disease ranged from 10 to 92 days (mean, 38.5 days). The size of defect after tumor ablation ranged from 9 cm× 6 cm to 18 cm×12 cm; the size of pedicled omentum flap ranged from 18 cm×10 cm to 22 cm×16 cm.

Results: According to the anatomical basis, the omentum was divided into 4 types, including thin type (42 cases, 20.5%), medium type (133 cases, 64.9%), hypertrophy type (24 cases, 11.7%), and absence type (6 cases, 2.9%). All omentum flaps survived successfully and the incisions healed by first intention. All patients were followed up 6-74 months (mean, 24.5 months); 83 cases were followed up more than 5 years. The shape, texture, and elasticity of the reconstructed breast were good and no flap contracture deformation happened. Only linear scar left at the donor sites, and the function of abdomen was not affected. No local recurrence happened.

Conclusion: The pedicled omentum flap can be harvested safely and reliable, which is the one of ideal option for breast reconstruction in breast cancer patients.

目的: 探讨带蒂大网膜瓣在乳腺癌术后乳房再造中的临床应用。.

方法: 2013 年 5 月—2017 年 10 月,对 205 例乳腺癌患者行改良根治术联合带蒂大网膜瓣移植再造乳房。患者均为女性;年龄 26~58 岁,平均 34.9 岁。左侧 127 例、右侧 78 例;肿瘤直径 2~5 cm,平均 2.9 cm。乳腺癌分期:Ⅰ期 120 例,Ⅱ期 85 例。病理诊断:浸润性导管癌 126 例,浸润性小叶癌 79 例。病程 10~92 d,平均 38.5 d。肿物切除后遗留缺损范围为 9 cm×6 cm~18 cm×12 cm。带蒂大网膜瓣切取范围为 18 cm×10 cm~22 cm×16 cm。.

结果: 根据术中观察的组织特点,将大网膜分为 4 种类型,稀薄型(42 例,20.5%)、中间型(133 例,64.9%)、肥厚型(24 例,11.7%)、缺如型(6 例,2.9%)。术后带蒂大网膜瓣均成活,切口Ⅰ期愈合。患者均获随访,随访时间 6~74 个月,平均 24.5 个月;其中 83 例随访达 5 年以上。再造乳房外形可、弹性好,无挛缩变形。供区仅遗留线性瘢痕,腹部功能无影响。随访期间无乳腺癌复发。.

结论: 带蒂大网膜瓣切取安全可靠、质地优良,是乳腺癌术后乳房再造的理想方法之一。.

Keywords: Breast cancer; breast reconstruction; pedicled omentum flap.

MeSH terms

  • Adult
  • Breast Neoplasms*
  • Female
  • Humans
  • Mammaplasty*
  • Mastectomy
  • Neoplasm Recurrence, Local
  • Omentum

Grants and funding

湖南省自然科学基金面上项目(2018JJ2241、2018JJ2242);湖南省自然科学基金科卫联合项目(2018JJ6028);湖南省肿瘤整形外科临床医学研究中心平台建设专项资助(2013TP4087)