Application of abdominal flap with vascular anastomosis in breast oncoplastic surgery

LYU Chun-liu; LI Zan; ZHOU Xiao; PENG Xiao-wei; ZHOU Bo; SONG Da-jiang

doi:10.3969/j.issn.1673-7040.2017.07.004

Abstract：Objective To explore the application of an abdominal flap with vascular anastomosis in breast oncoplastic surgery.Methods From March 2014 to March 2016,the cases of 60 breast cancer patients were retrospectively analyzed.All cases underwent one-stage breast reconstruction by abdominal flaps or wound healing after tumor excision.Different numbers of vascular anastomosis were performed intraoperatively.Results Fifty cases underwent one-stage breast reconstruction and 10 cases under went wound healing by abdominal flaps with vascular anastomosis after tumor excision.Among them,10 cases underwent pedicled TRAM flap+SIEV anastomosed,40 cases underwent DIEP flap,8 cases underwent pedicled TRAM + contralateral DIEP flap,and 2 cases underwent double pedicle DIEP flap.There were 2 cases of vascular crisis,2 cases of incision infection,2 cases of partial necrosis of the Zone Ⅳ flap,2 cases of abdominal distention,1 case of hematoma,1 case of fat liquefaction under the flap,1 case of donor fat hquefaction,and 1 case of umbilical necrosis,postoperative.No abdominal hernia or other complications occurred.During the follow-up from 6 to 29 months,there were 2 cases of distant metastasis,1 case of local recurrence and 3 cases were lost to follow-up.The overall satisfaction of the patients with mammary reconstruction was high,and quality of life was significantly improved.The postoperative wounds were repaired in a timely manner.Conclusions The application of abdominal flaps with vascular anastomosis for breast reconstruction or wound healing can achieve reliable blood supply and satisfactory clinical results.