Abstract:
Objective To summarize the clinical experience of breast reconstruction using transverse rectus abdominis myocutaneous flap transplantation with lymphatic tissues in the treatment of the upper limb lymphedema.
Methods One patient presenting with lymphedema of the right upper limb at 7 years after radical mastectomy for breast cancer was admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences.She was diagnosed with axillary lymphatic flow disorders by preoperative lymphography.The transverse rectus abdominis myocutaneous flap with lymphatic tissue was used for chest wall repair, breast reconstruction and lymphatic flow reconstruction, and thoroughly relieved the severe axillary contracture scars.The circumferences of bilateral upper limbs of the patient were monitored postoperatively for long term.
Results After the operation, severe edema occurred in the transplant skin flap.The postoperative drainage volume reached 755 mL/d for 5 d, accompanied by multiple postoperative complications, such as atrial fibrillation, hypoproteinemia, hypokalemia and delayed incisional healing.After timely drainage and standardized comprehensive treatment, excellent postoperative outcomes were obtained.The circumference of the affected upper limb was gradually decreased.The patient was stabilized at postoperative 3 weeks.Excellent surgical efficacy was achieved during 5-year follow-up.
Conclusions Transverse rectus abdominis myocutaneous flap transplantation with lymphatic tissues for breast reconstruction is an efficacious treatment of the upper limb lymphedema after radical mastectomy for breast camcer.
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