采用带蒂胸壁穿孔皮瓣（CWPF）的局部乳房重建术可以实现较高肿瘤：乳房体积比例情况下的乳房保留。由于证据有限，本回顾性队列研究旨在确定即刻（30天）和中期（随访时间）手术结果。符合STROBE规范的方案确保了2011年3月至2021年3月之间的CWPF结果。邀请进行CWPF手术的英国中心参与研究，要求每个中心至少进行10例手术。回顾性收集数据，包括患者人口统计学特征、肿瘤和治疗特征以及手术和肿瘤学结果。统计分析（R™）包括多变量逻辑回归和敏感性分析。在15个中心共有507名患者中，中位年龄为54岁，四分位距为48-62岁，身体质量指数为25.4 kg/m2，四分位距为22.5-29，肿瘤大小为26 mm，四分位距为18-35，取材重量为62 g，四分位距为40-92。不同类型的皮瓣如下：LiCAP（54.1%，n = 273）， MiCAP/AiCAP（19.6%，n = 99），LiCAP + LTAP（19.8%，n = 100）和TDAP（2.2%，n = 11）。30天的并发症发生率为12%：血肿（4.3%，n = 22），伤口感染（4.3%，n = 22），延迟创口愈合（2.8%，n = 14）和皮瓣损失（0.6%，n = 3；1个完全损失），导致重新入院（2.6%，n = 13）和再次手术（2.6%，n = 13）。有15.9%的阳性切缘（n = 79）引发了15.9%的切缘重复切除（n = 79），其中包括7.5%的计划性两阶段手术的第二阶段切除（n = 37）和1.8%的乳房切除术（n = 9）。在中位23个月（四分位距；11-39个月）的随访中，有1.2%（n = 6）的对称手术；复发：局部（1%），区域/淋巴结（0.6%）和远处（3.2%）。这项大型多中心队列研究表明了可接受的并发症和切缘重复切除率。CWPF扩展了乳房保育技术的范围。需要进一步研究乳腺癌的长期肿瘤学结果。© 2023 The Authors. 由Elsevier Ltd.出版。版权所有。

Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes.STROBE-compliant protocol ascertained CWPF outcomes between March 2011-March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (R™) included multivariable logistic regression and sensitivity analysis.Across 15 centres, 507 patients with median age (54 years, IQR; 48-62), body mass index (25.4 kg/m2, IQR; 22.5-29), tumour size (26 mm, IQR; 18-35), and specimen weight (62 g, IQR; 40-92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11-39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/nodal (0.6%) and distant (3.2%).This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.