摘要目的:探讨上腹壁全层推进皮瓣在下象限乳腺癌保乳手术中的应用效果。方法:本研究为回顾性病例系列研究。回顾性分析2022年6月至2023年9月在首都医科大学附属北京同仁医院乳腺中心接受保乳手术并通过上腹壁全层推进皮瓣修复乳房缺损的25例下象限乳腺癌患者的临床资料。患者均为女性，年龄（47.6±5.8）岁（范围：38~57岁）。肿瘤分期：Ⅰ期8例，ⅡA期13例，ⅡB期4例。测量并记录术前上腹壁供区皮下脂肪厚度、切除标本体积，记录乳房外形修复的手术时间、术后引流时间、术后并发症情况及患者对乳房外形修复的满意度。结果:上腹壁供区皮下脂肪厚度为（1.7±0.2）cm（范围：1.3~2.2 cm），切除标本体积为（70.8±13.6）mm 3（范围：49~97 mm 3），修复乳房外形的手术时间为（55.4±5.1）min（范围：45~65 min），术后引流时间为（7.4±0.8）d（范围：6~9 d）。术后患者对乳房外形修复的满意度：优12例（48.0%）、良9例（36.0%）、中4例（16.0%）。术后发生供区血清肿1例，重新放置负压引流管后痊愈。 结论:在乳房下象限乳腺癌的保乳手术中，利用上腹壁全层推进皮瓣修复乳房缺损，是一种简单、有效的肿瘤整形术式，在实现术后乳房下象限对称性方面有较好效果。

abstractsObjective:To explore the application of full-thickness advancement flap of upper abdominal wall in breast-conserving surgery for lower quadrant breast cancer.Methods:This is a retrospective case series study. The clinic data of 25 lower quadrant breast cancer patients who underwent a breast-conserving surgery with advancement flap of full-thickness of upper abdominal wall at the Breast Center, Beijing Tongren Hospital, Capital Medical University, from June 2022 to September 2023 were analyzed retrospectively. All patients were female, aged (47.6±5.8) years (range: 38 to 57 years). Tumor staging included stageⅠ in 8 cases, stageⅡA in 13 cases, stageⅡB in 4 cases. The subcutaneous fat thickness of the upper abdominal walls and the volume of wide local excision of the tumor were measured and recorded. The operation time of repairing the breast, the duration of retention of postoperative drainage tubes, postoperative complications, and cosmetic results were recorded.Results:The subcutaneous fat thickness in the upper abdominal walls was (1.7±0.2) cm (range: 1.3 to 2.2 cm), the excision volume of breast-conserving surgery was (70.8±13.6) mm 3 (range: 49 to 97 mm 3), the operation time of repairing the breast was (55.4±5.1) minutes (range: 45 to 65 minutes) and the retention time of the drainage tube was (7.4±0.8) days (range: 6 to 9 days). Cosmetic results: excellent in 12 cases (48.0%), good in 9 cases (36.0%) and fair in 4 cases (16.0%). There was 1 case of postoperative seroma in the donor area, which healed after repositioning the negative pressure drain. Conclusion:In breast-conserving surgery for lower quadrant breast cancer, using a full-thickness abdominal wall advancement flap to repair breast defects is a simple and effective tumor reconstructive technique, yielding good results in achieving postoperative symmetry of the lower quadrant of the breast.