진행성 유방암에 있어 유방 절제술 후 발생한 광범위 피부 결손 부위의 가슴배피판을 이용한 흉벽 재건술 (Chest Wall Reconstruction with Thoracoabdominal Flap for Large Skin Defects after Mastectomy of Advanced Breast Cancer)

서지정보

· 발행기관 : 대한성형외과학회
· 수록지 정보 : Archives of Plastic Surgery / 37권 / 6호 / 736 ~ 741페이지
· 저자명 : 김학태, 양정덕, 정호윤, 조병채, 김귀락, 최강영, 이정훈, 박호용

초록

Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap.
Methods: From August of 2008 to June of 2009. There are 4 cases of thoraco - abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly.
Results: Their mean age, 55.7 years and the average follow - up interval was 9 months. Patients' oncologic status ranged from stage Ⅲc to stage Ⅳ, it was classified according to the TNM staging system. Flap dimensions ranged between 15 × 15 and 25 × 25 cm. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap.
Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single - stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

영어초록

Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap.
Methods: From August of 2008 to June of 2009. There are 4 cases of thoraco - abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly.
Results: Their mean age, 55.7 years and the average follow - up interval was 9 months. Patients' oncologic status ranged from stage Ⅲc to stage Ⅳ, it was classified according to the TNM staging system. Flap dimensions ranged between 15 × 15 and 25 × 25 cm. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap.
Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single - stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

참고자료

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