| Optimization strategies for thoracic wall reconstruction and repairing the huge soft-tissue defects after locally advanced breast cancer resection based on 11 years clinical experiences in a single Chinese center |
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| Citation of this paper:ZHU Ming1△, MA Xiao-fei2△, YANG Yan-wen1, ZHANG Yong1*, FENG Zi-hao1*, QI Fa-zhi1, GU Jian-ying1.Optimization strategies for thoracic wall reconstruction and repairing the huge soft-tissue defects after locally advanced breast cancer resection based on 11 years clinical experiences in a single Chinese center[J].Chinese Journal of Clinical Medicine,2018,25(2):182-187 |
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| Author Name | Affiliation | | ZHU Ming1△, MA Xiao-fei2△, YANG Yan-wen1, ZHANG Yong1*, FENG Zi-hao1*, QI Fa-zhi1, GU Jian-ying1 | 1. Department of Orthopaedics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2. Yuyan Plastic Clinic, Beijing 100000, China |
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| Abstract:Objective：To review and summarize our experience of surgical approach and reconstructive strategy for locally advanced breast cancer (LABC). Methods：A retrospective study was conducted using the medical records of 252 patients who underwent LABC treatment in our department from March 2006 to August 2017. Totally 197 of them were primary tumor and 55 were secondary. All the patients were received neoadjuvant chemotherapy. Surgical technology and clinical outcomes were compared and statistical analyzed. Results：The average hospital stay time of these patients was (12.9±3.4) d（9-45 d）, and the follow-up period after surgery was (18.7±9.6) months (5-72 months). The size of tumor ranged 30 cm×25 cm to 5 cm×13 cm. 71 of these cases had the whole chest wall defect, which 41 of them reconstructed with titanium mesh to establish the stability of chest. The sizes of flaps for reconstructing soft tissue defects ranged 14 cm×6 cm-29 cm×30 cm. Different flaps were selected for covering the chest wall defect, which local flaps for 16 case（6.3%）; pectoralis major myocutaneous combined with breast flaps for 31 cases （12.3%）; lateral thoracic flaps for 34 cases (13.5%); latissimus dorsi myocutaneous flaps with pedicle for 98 cases （38.9%） ; rectus abdominis musculocutaneous flaps for 56 cases （22.2%）and deep inferior epigastric perforator flaps (DIEP flaps) for 17 cases（6.7%）. All the patients recovered well, and the function and appearance of chest wall were satisfactory （P<0.05）. Conclusions：Plastic technology for reconstruction provides a useful strategy and method for LABC treatment, and is able to improve the life quality and prognosis of the patients. |
| keywords:locally advanced breast cancer surgical treatment chest wall defect chest wall reconstruction |
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