Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHAI Lijun ¹ ,  ZHANG Xuehui ²

1. Department of Breast, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, 450014, P.R.China;
2. Department of Breast Reconstruction, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, P.R.China;

Corresponding?author：

ZHANG Xuehui, Email: jbaozheng@126.com

Keywords：

Breast cancer; modified radical mastectomy; breast reconstruction; serratus anterior muscle flap; implant

DOI：

10.7507/1002-1892.201704032

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ObjectiveTo investigate effectiveness of the combination of serratus anterior muscle flap and breast implants for breast reconstruction after modified radical mastectomy.MethodsBetween January 2015 and December 2015, 25 female patients with breast cancer were enrolled, aged 24-62 years (mean, 40.6 years). The tumor located at left side in 9 cases and right side in 16 cases; 14 cases were in the left upper quadrant, 4 cases were in the left lower quadrant, 7 cases were on the top of the breast. All cases were invasive ductal carcinoma. According to TNM staging, 14 cases were at stageⅠand 11 cases were at stageⅡA. The diameter of lumps were all less than 3 cm. All those lumps were solitary and without distant metastasis. The sentinel nodes were all negative. After modified radical mastectomy, the breasts were reconstructed by serratus anterior muscle flap and breast implants. The nipples were spared in 22 cases.ResultsThe operation time was 113-148 minutes (mean, 136 minutes). All breasts survived and incisions healed at stageⅠ. There was no complication such as hematoma, infection, etc. All patients were followed up 6-18 months (mean, 15 months). Except 1 case, the others were evaluated according to the criteria of the reconstructed breast at 12 months after operation. Among them, 23 cases were evaluated as good and 1 case as fair. There was no tumor recurrence during the follow-up period.ConclusionThe combination of serratus anterior muscle flap and breast implants after the modified radical mastectomy is a handy approach of breast reconstruction which is less harmful with few postoperative complications. It also gains a high degree of satisfaction from patients for good breast shape.

Citation： CHAI Lijun, ZHANG Xuehui. Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(9): 1098-1101. doi: 10.7507/1002-1892.201704032 Copy

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6.	Chirappapha P, Somintara O, Lertsithichai P, et al. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients. Gland Surg, 2016, 5(4): 405-415.
7.	李德全, 劉劍侖, 莫欽國, 等. 乳房再造時假體的" 四維法”選擇. 中國癌癥防治雜志, 2010, 2(3): 183-186.
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9.	尹健, 張學慧, 肖春華, 等. 背闊肌肌皮瓣在乳房再造中的應用. 中華整形外科雜志, 2007, 23(6): 499-501.
10.	羅益竹, 張奇齡, 朱光瓊, 等. 前鋸肌的解剖學研究. 四川解剖學雜志, 2016, 24(1): 12-14.
11.	祁佐良, 李青峰. 外科學: 整形外科分冊. 北京: 人民衛生出版社, 2016: 310-313.
12.	Teisch LF, Gerth DJ, Tashiro J, et al. Latissimus dorsi flap versus pedicled transverse rectus abdominis myocutaneous breast reconstruction: outcomes. J Surg Res, 2015, 199(1): 274-279.
13.	Reitsamer R, Peintinger F. Prepectoral implant placement and complete coverage with porcine acellular dermal matrix: a new technique for direct-to-implant breast reconstruction after nipple-sparing mastectomy. J Plast Reconstr Aesthet Surg. 2015, 68(2): 162-167.
14.	Bordoni D, Cadenelli P, Rocco N, et al. Serratus Anterior Fascia Flap Versus Muscular Flap for Expander Coverage in Two-stage Breast Reconstruction Following Mastectomy: Early Post-operative Outcomes. Aesthetic Plast Surg, 2017, 41(1): 26-30.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. 陳萬青, 鄭榮壽, 張思維. 中國惡性腫瘤的動態變化. 科技導報, 2014, 32(26): 65-71.
3. 馬貞, 于明薇, 徐雯潔, 等. 乳腺癌患者癌因性疲乏與抑郁、焦慮情緒的調查. 臨床腫瘤學雜志, 2012, 17(11): 984-987.
4. 曹旭晨, 李樹玲. 乳腺切除術后即刻乳房再造術式的選擇. 中國腫瘤臨床, 2007, 34(14): 837-840.
5. Huang NS, Quan CL, Ma LX, et al. Current status of breast reconstruction in China: an experience of 951 breast reconstructions from a single institute. Gland Surg, 2016, 5(3): 278-286.
6. Chirappapha P, Somintara O, Lertsithichai P, et al. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients. Gland Surg, 2016, 5(4): 405-415.
7. 李德全, 劉劍侖, 莫欽國, 等. 乳房再造時假體的" 四維法”選擇. 中國癌癥防治雜志, 2010, 2(3): 183-186.
8. 龔益平, 吳新紅, 韓寶三, 主譯. 乳房重建圖譜. 北京: 北京大學醫學出版社, 2016: 6-8.
9. 尹健, 張學慧, 肖春華, 等. 背闊肌肌皮瓣在乳房再造中的應用. 中華整形外科雜志, 2007, 23(6): 499-501.
10. 羅益竹, 張奇齡, 朱光瓊, 等. 前鋸肌的解剖學研究. 四川解剖學雜志, 2016, 24(1): 12-14.
11. 祁佐良, 李青峰. 外科學: 整形外科分冊. 北京: 人民衛生出版社, 2016: 310-313.
12. Teisch LF, Gerth DJ, Tashiro J, et al. Latissimus dorsi flap versus pedicled transverse rectus abdominis myocutaneous breast reconstruction: outcomes. J Surg Res, 2015, 199(1): 274-279.
13. Reitsamer R, Peintinger F. Prepectoral implant placement and complete coverage with porcine acellular dermal matrix: a new technique for direct-to-implant breast reconstruction after nipple-sparing mastectomy. J Plast Reconstr Aesthet Surg. 2015, 68(2): 162-167.
14. Bordoni D, Cadenelli P, Rocco N, et al. Serratus Anterior Fascia Flap Versus Muscular Flap for Expander Coverage in Two-stage Breast Reconstruction Following Mastectomy: Early Post-operative Outcomes. Aesthetic Plast Surg, 2017, 41(1): 26-30.

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Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy

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