摘要目的 对乳腺癌患者采用保留部分前鞘的下腹部横行腹直肌肌皮瓣(TRAM瓣)进行一期乳房再造,并探讨降低术后腹壁疝、腹壁膨出发生率的方法.方法 对2002至2004年接受乳腺癌根治术的16例患者(一、二期9例,三期7例),于根治术同期采用保留部分前鞘的TRAM瓣术式再造乳房.结果 本组16例再造乳房与对侧基本对称12例,不对称的4例中,3例为对侧乳房中度以上下垂,1例为再造乳房偏小.术后随访平均2年5个月,所有病例的TRAM瓣均存活,仅1例发生腹壁膨隆.结论 部分筋膜法TRAM瓣一期再造乳房,可保持传统TRAM瓣手术的效果并能降低术后腹壁并发症发生率.

abstractsObjective To investigate the clinical application of TRAM-RPAS flap in the one-stage breast reconstruction for patients with breast cancer, and to discuss the method to reduce the incidence of abdominal hernia and abdominal bulging. Methods From 2002 to 2004 , 16 cases of breast cancer (9 cases in stsge Ⅰ or Ⅱ and 7 in stage Ⅲ) received radical resection and breast reeonstrnction with TRAM-RPAS flaps at the same stage. Results Good symmetry was achieved in 12 eases. In the other 4 eases, 3 cases had moderate breast poptosis and one case had breast hypoplasia on the unaffected side. All the flaps survived with only one ease of abdominal bulging. Conclusions TBAM-BPAS flap can achieve the same result as traditional TBAM-RPAS flap in the one-stage breast reconstruction, while the incidence of abdominal complication is lower for TBAM-BPAS flap.