[Application of dual-pedicle abdominal flap for unilateral breast reconstruction].

目的: 探讨双蒂腹部皮瓣单侧乳房再造的临床效果。. Methods: Between March 2014 and March 2018, a clinical data of 19 female patients underwent dual-pedicle abdominal flap reconstruction because of unilateral mastectomy defect was reviewed retrospectively. The median age was 45 years (range, 32-51 years), including 3 immediate breast reconstruction and 16 delayed breast reconstruction, and left side in 7 cases and right side in 12 cases. Unilateral breast reconstruction were performed for 8 patients with unilateral pedicle transverse rectus abdominis musculocutaneous (TRAM) flap and contralateral free TRAM flap, for 3 patients with pedicle TRAM flap and contralateral deep inferior epigastric perforator (DIEP) flap, for 7 patients with bilateral DIEP flaps, for 1 patient with free muscle-sparing TRAM flap and contralateral DIEP flap. The size of abdominal flap ranged from 24 cm×7 cm to 43 cm×13 cm. The donor sites were closed directly. 结果: 术后 1 例发生皮瓣血管危象，经探查处理后缓解；1 例腹部切口愈合不良，经清创后愈合。其余皮瓣均顺利成活，供区切口均Ⅰ期愈合。术后患者均获随访，随访时间 4～42 个月，中位时间 12 个月。术后 4 例行再造乳房修整术，2 例因对侧乳房下垂行对侧乳房下垂矫正术。末次随访时采用 BREAST-Q 评分系统评价，腹部评分为（84.1±11.7）分，胸部评分为（86.5±8.9）分，乳房评分为（67.6±16.4）分。. 结论: 对于体型较纤瘦以及存在腹部切口瘢痕尤其是纵行切口的患者，双蒂腹部皮瓣能够提供充足组织量和良好血供，是一种较好的自体组织单侧乳房再造方法。.