自体组织移植被认为是乳房重建患者的金标准，并且在放射治疗后是首选方法。尽管背阔肌肌瓣（LDF）已被腹部瓣取代为首选技术，但在几种特定临床情况下仍然是一种有价值的选择，并且近年来其使用量有所增加。本研究回顾性分析了德国Regio Klinikum Pinneberg认证的乳腺癌中心于2005年4月1日至2022年10月31日期间进行的LDF为基础的重建手术的单机构和单外科医生经验，重点关注早期并发症和重建失败。回顾了德国Regio Klinikum Pinneberg认证的乳腺癌中心于2005年4月1日至2022年10月31日期间，因任何原因接受乳房手术的所有患者的住院记录。共鉴定了142例连续的LDF为基础的重建手术。收集了关于患者特征、治疗相关因素和并发症的详细信息。其中140名患者（139名女性，1名男性）接受了142例LDF为基础的手术。该瓣片主要用于即时乳房重建（带或不带植入物）（占患者的83%），其次是大肿瘤切除后的缺损修复（占患者的7%），植入物到瓣片的转换（带或不带新植入物）（占患者的6%），以及延迟乳腺切除术后重建（占患者的4%）。LDF的使用量在2005年至2020年期间逐渐减少（2005年：17例，2006年：13例，2007年：14例，2008年：16例，2009年：5例，2010年：9例，2011年：8例，2012年：3例，2013年：10例，2014年：8例，2015年：8例，2016年：7例，2017年：7例，2018年：4例，2019年：4例，2020年：2例，2021年：6例，2022年：4例）。手术主要用于侵袭性乳腺癌（占患者的78%）、导管内乳癌（占患者的20%）和其他原因（如遗传突变，占患者的1%）。在接受LDF手术之前接受同侧乳腺放疗的患者占12%，术后接受同侧乳房放疗的患者占37%。有25%的患者吸烟。手术的中位手术时间，包括同时进行的所有程序（如切除乳房、腋下手术或植入物置入等），为117分钟（范围为56-205分钟）。患者住院时间的中位数为7天（范围为2-23天）。最常见的并发症是积液（占26%），其次是切口裂开（占8%）、手术切口感染（占7%）、任何大小的部分皮肤和/或乳头坏死（占7%）以及需要手术排空的血肿（占2%）。所有患者中有19%需要积液穿刺或引流，主要在捐献部位进行超声引导下的门诊操作。2%的患者发生了由于坏死导致的瓣失血。背阔肌瓣是一种已经建立起来的外科技术，常用于即时乳房重建以及可并发局部晚期乳腺癌等缺损修复。据我们所知，这是对接受LDF的患者早期并发症进行最大规模的单外科医生分析之一。如我们所预期的，积液是近三分之一患者最常见的并发症，并且每五名患者中有一名需要治疗干预措施。严重不良事件很少发生，瓣失血率非常低。©2023作者。

The use of autologous tissues is considered gold standard for patients undergoing breast reconstruction and is the preferred method in the post-radiation setting. Although the latissimus dorsi flap (LDF) has been replaced by abdominal flaps as technique of choice, it remains a valuable option in several specific clinical situations and its use has been regaining popularity in recent years. In this work, we present an 18-year retrospective analysis of a single-institution single-surgeon experience with LDF-based reconstruction with focus on early complications and reconstructive failures.Hospital records of all patients undergoing breast surgery for any reason in the Certified Breast Cancer Center, Regio Klinikum Pinneberg, Germany between April, 1st 2005 and October, 31st 2022 were reviewed. 142 consecutive LDF-based reconstructive procedures were identified. Detailed information was gathered on patient characteristics, treatment-related factors, and complications.One hundred forty patients (139 female, 1 male) received 142 LDF-based surgeries. The flap was used mainly for immediate breast reconstruction with or without implant (83% of patients), followed by defect coverage after removal of a large tumor (7%), implant-to-flap conversion with or without placement of a new implant (6%), and delayed post-mastectomy reconstruction (4%). The use of LDF decreased between 2005 and 2020 (2005: 17, 2006: 13, 2007: 14, 2008: 16, 2009: 5, 2010: 9, 2011: 8, 2012: 3, 2013: 10, 2014: 8, 2015: 8, 2016: 7, 2017: 7, 2018: 4, 2019: 4, 2020: 2, 2021: 6, 2022: 4). Surgery was performed for invasive breast cancer in 78%, ductal carcinoma in situ in 20% and other reasons such as genetic mutation in 1% of patients. Ipsilateral radiation therapy was received by 12% of patients prior to LDF surgery and by 37% after the surgery. 25% of patients were smokers. The median duration of surgery, including all procedures conducted simultaneously such as e.g., mastectomy, axillary surgery, or implant placement, was 117 min (range 56-205). Patients stayed in the hospital for a median of 7 days (range 2-23 days). The most common complication was seroma (26%), followed by wound dehiscence (8%), surgical site infection (7%), partial skin and/or nipple necrosis of any size (7%) and hematoma requiring surgical evacuation (2%). 19% of all patients required seroma aspiration or drainage, mostly at the donor site and performed under ultrasound guidance in the ambulatory setting. Flap loss due to necrosis occurred in 2% of patients.Latissimus dorsi flap is a well-established surgical technique commonly used for immediate breast reconstruction as well as defect coverage in locally advanced breast cancer. To the best of our knowledge, this is one of the largest single-surgeon analyses of early complications in patients receiving LDF. As expected, seroma was the most common complication observed in nearly one third of patients and requiring a therapeutic intervention in every fifth patient. Serious adverse events occurred rarely, and flap loss rate was very low.© 2023. The Author(s).