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題名 | Breast Reconstruction with a Muscle-Sparing Free Transverse Rectus Abdominis Myocutaneous Flap: Comparison between Immediate and Delayed Groups=以自由式肌肉保留橫腹直肌皮瓣重建乳房:立即性及延遲性重建之比較 |
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作者 | 黃綺烽; 鄭明輝; 陳訓徹; 羅永豐; 葉大森; 陳煥棠; 黃維超; 魏福全; | 書刊名 | 長庚醫學 |
卷期 | 27:4 2004.04[民93.04] |
頁次 | 頁275-282 |
分類號 | 416.226 |
關鍵詞 | 自由式肌肉保留橫腹直肌皮瓣; 乳房切除; 乳房重建; Muscle-sparing free transverse rectus abdominis myocutaneous flap; TRAM; Mastectomy; Breast reconstruction; |
語文 | 英文(English) |
中文摘要 | 背景:乳房重建不僅能在外表上將失去的乳房還原,對於病患心理上的重建格外具有意義。以自體組織的自由皮瓣來重建乳房是一種好的選擇。本研究的目的在探討以自由式肌肉保留橫腹直肌皮瓣重乳房的成功率,併發症及外觀結果。 方法:自1999年8月至2001年2月期間,共有15位乳癌病患接受乳房切除後,以自由式肌肉保留橫腹直肌皮瓣來重建乳房。10位病人於長庚紀念醫院接受乳房切除及立即性自由式肌肉保留橫腹直肌皮瓣重建,5位先前於他院接受乳房切除的病人則接受延遲性重建。 結果:平均年齡為43.9歲。手術成功率為93.3%。術後併發症包括一例腹部組織液瘤,一例小部份乳房脂肪壞死。10位立即性重建的病人中有6位接受術後化學及賀爾蒙治療,3位僅接受術後化學治療。腫瘤的術後化學治療均無受到重建手術的影響。在為期平均26.7個月的追蹤當中,並無發現腫瘤再發,且病人的滿意度為93%。 結論:以自由式肌肉保留腹直肌皮瓣重建乳房是一種很好的選擇。不僅成功率高,病人的滿意度也高。同時立即性重建也不會影響腫廇的輔助治療。 |
英文摘要 | Backgorund: Breast reconstruction offers not only physical but also psychological rehabilitation. Autologous tissue transfer is a good option for breast reconstruction. The purpose of this study was to investigate the success rate, complications, and cosmetic outcomes following use of a muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap for breast reconstruction. Methods: Between August 1999 and February 2001, 15 consecutive patients underwent breast reconstruction using a muscle-sparing free TRAM flap after a mastectomy. Ten patients received mastectomies and immediately underwent breast reconstruction using muscle-sparing free TRAM flaps at Chang Gung Memorial Hospital. The remaining 5 patients first received a modified radical mastectomy and then underwent breast reconstruction. Results: The mean age of patients was 43.9 (range, 32 to 50)years. Ten patients (67%) underwent immediate reconstructions, and 5(23%) underwent delayed reconstructions. The overall success rate was 93.3%. Postoperative complications included 1 abdominal seroma and 1 small area of breast fat necrosis. Six of 10 patients with immediate reconstruction underwent both adjuvant chemotherapy and hormone therapy, while 3 patients received only chemotherapy. None of these adjuvant therapies were delayed by the reconstructive surgery. At a mean follow-up of 26.7 months, no local recurrence had been found, and 93% of patients were satisfied with the esthetic results. Conclusions: A muscle-sparing free TRAM flap is a good option for breast reconstruction. Both the success rate and patients satisfaction are high. The subsequent adjuvant therapy need not be delayed following immediate reconstruction. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。