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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rpmj</journal-id><journal-title-group><journal-title xml:lang="ru">Research'n Practical Medicine Journal</journal-title><trans-title-group xml:lang="en"><trans-title>Research and Practical Medicine Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2410-1893</issn><publisher><publisher-name>"QUASAR", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17709/2410-1893-2021-8-3-10</article-id><article-id custom-type="elpub" pub-id-type="custom">rpmj-702</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Review</subject></subj-group></article-categories><title-group><article-title>Реконструкция молочной железы с использованием лоскута на перфоранте глубокой нижней эпигастральной артерии (DIEP-flap). История развития</article-title><trans-title-group xml:lang="en"><trans-title>Breast reconstruction with deep inferior epigastric artery perforator flap (DIEP-flap). History of development</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9577-584X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дуадзе</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Duadze</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дуадзе Илона Селимовна – аспирант кафедры онкологии, радиологии и пластической хирургии института клинической медицины, SPIN: 4663-9473, AuthorID: 1101806</p><p>119991,  г. Москва, ул. Трубецкая, д. 8, стр. 2; 125284,  г. Москва, 2-й Боткинский проезд, д. 3</p></bio><bio xml:lang="en"><p>Ilona S. Duadze – PhD student at the Department of Oncology, Radiology and Plastic Surgery of the Institute, SPIN: 4663-9473, AuthorID: 1101806</p><p>8/2 Trubetskaya str., Moscow 119991; 3 2nd Botkinskiy travel, Moscow 125284</p></bio><email xlink:type="simple">ilona.duadze@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7141-2502</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зикиряходжаев</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Zikiryakhodzhaev</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зикиряходжаев Азизжон Дильшодович – д.м.н., доцент кафедры онкологии, радиологии и пластической хирургии института клинической медицины; заведующий отделением онкологии и реконструктивно-пластической хирургии молочной железы и кожи;  профессор кафедры онкологии и рентгенорадиологии , SPIN: 8421-0364, AuthorID: 701248</p><p>119991,  г. Москва, ул. Трубецкая, д. 8, стр. 2; 125284,  г. Москва, 2-й Боткинский проезд, д. 3;  117198, г. Москва, ул. Миклухо-Маклая, д. 6</p></bio><bio xml:lang="en"><p>Aziz D. Zikiryakhodzhaev – Dr. Sci. (Med.), associate Professor at the Department of Oncology, Radiology and Plastic Surgery of the Institute of Clinical Medicine; Head of the Department of Oncology and ReconstructivePlastic Surgery of the breast and skin ; Professor of the Department of Oncology and Radiology, SPIN: 8421-0364, AuthorID: 701248</p><p>8/2 Trubetskaya str., Moscow 119991; 3 2nd Botkinskiy travel, Moscow 125284; 6 Miklukho-Maklaya str., Moscow 117198</p></bio><email xlink:type="simple">azizz@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2337-5919</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сухотько</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Sukhotko</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сухотько Анна Сергеевна – к.м.н., врач-онколог онкохирургического отделения №71, SPIN: 2391-6469, AuthorID: 812052</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 5</p></bio><bio xml:lang="en"><p>Anna S. Sukhotko – Cand. Sci. (Med.), MD, oncologist of the oncosurgical department №71, SPIN: 2391-6469, AuthorID: 812052</p><p>2 Botkinsky proezd, 5, Moscow 125284</p></bio><email xlink:type="simple">syxotya26@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4141-8414</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Старкова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Starkova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Старкова Марианна Валентиновна – к.м.н., научный сотрудник отделения онкологии и реконструктивно-пластической хирургии молочной железы икожи, SPIN: 7758-8806, AuthorID: 973557</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p></bio><bio xml:lang="en"><p>Marianna V. Starkova – Cand. Sci. (Med.), researcher of the Department of Oncology and Reconstructive Plastic surgery of the breast and skin,  SPIN: 7758-8806, AuthorID: 973557</p><p>3 2nd Botkinskiy travel, Moscow 125284</p></bio><email xlink:type="simple">mariannastarkova@gmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9510-1434</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Усов</surname><given-names>Ф. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Usov</surname><given-names>F. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Усов Федор Николаевич – к.м.н., врач-онколог отделения онкологии и реконструктивно-пластической хирургии молочной железы и кожи, SPIN: 9254-2294, AuthorID: 778307</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p></bio><bio xml:lang="en"><p>Fedor N. Usov – Cand. Sci. (Med.), MD, oncologist at the Department of Oncology and reconstructive plastic surgery of the breast and skin, SPIN: 9254-2294, AuthorID: 778307</p><p>3 2nd Botkinskiy travel, Moscow 125284</p></bio><email xlink:type="simple">fedus70@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9195-4181</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Багдасарова</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Bagdasarova</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Багдасарова Дарья Валерьевна – аспирант, SPIN: 6237-2159, AuthorID: 1037840</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p></bio><bio xml:lang="en"><p>Daria V. Bagdasarova – PhD student, SPIN: 6237-2159, AuthorID: 1037840</p><p>3 2nd Botkinskiy travel, Moscow 125284</p></bio><email xlink:type="simple">dasha.bagdasarova@gmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7283-2530</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Джабраилова</surname><given-names>Д. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Dzhabrailova</surname><given-names>D. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Джабраилова Джамиля Шринбековна – врач-онколог общеклинического отдела, SPIN: 7557-6089, AuthorID: 1065769</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p></bio><bio xml:lang="en"><p>Dzhamilya Sh. Dzhabrailova – MD, oncologist at the general clinical department, SPIN: 7557-6089, AuthorID: 1065769</p><p>3 2nd Botkinskiy travel, Moscow 125284</p></bio><email xlink:type="simple">jamijabrailova17@gmail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6660-4649</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хакимова</surname><given-names>Ш. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Khakimova</surname><given-names>Sh. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хакимова Шахноз Голибовна – к.м.н., доцент кафедры детской хирургии и курса онкологии, SPIN: 6619-6957, AuthorID: 1000839</p><p>100140, Республика Узбекистан, г. Ташкент, Юнусабадский район, ул. Богишамол, д. 223</p></bio><bio xml:lang="en"><p>Shakhnoza G. Khakimova – Cand. Sci. (Med.), associate Professor of the Department of Pediatric Surgery and Oncology Course, SPIN: 6619-6957, AuthorID: 1000839</p><p>223 Bogishamol str., Yunusabad district, Tashkent 100140</p></bio><email xlink:type="simple">shahnoz_hakimova@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский университет); МНИОИ им. П.А.Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M.Sechenov First Moscow State Medical University (Sechenov University); P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский университет);  МНИОИ им. П.А.Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России; ФГАОУ ВО «Российский университет дружбы народов»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M.Sechenov First Moscow State Medical University (Sechenov University); P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre; Peoples Friendship University of Russia (RUDN University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ ГКБ им. С.П.Боткина ДЗМ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>S.P.Botkin City Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>МНИОИ им. П.А.Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Ташкентский педиатрический медицинский институт</institution><country>Узбекистан</country></aff><aff xml:lang="en"><institution>Tashkent Pediatric Medical Institute</institution><country>Uzbekistan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>23</day><month>09</month><year>2021</year></pub-date><volume>8</volume><issue>3</issue><fpage>108</fpage><lpage>117</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дуадзе И.С., Зикиряходжаев А.Д., Сухотько А.С., Старкова М.В., Усов Ф.Н., Багдасарова Д.В., Джабраилова Д.Ш., Хакимова Ш.Г., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Дуадзе И.С., Зикиряходжаев А.Д., Сухотько А.С., Старкова М.В., Усов Ф.Н., Багдасарова Д.В., Джабраилова Д.Ш., Хакимова Ш.Г.</copyright-holder><copyright-holder xml:lang="en">Duadze I.S., Zikiryakhodzhaev A.D., Sukhotko A.S., Starkova M.V., Usov F.N., Bagdasarova D.V., Dzhabrailova D.S., Khakimova S.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpmj.ru/rpmj/article/view/702">https://www.rpmj.ru/rpmj/article/view/702</self-uri><abstract><p>Статья посвящена актуальной на сегодняшний день теме реконструкции молочной железы аутологичными тканями, в ней авторы рассматривают ключевые этапы развития реконструктивно-пластической хирургии молочной железы с использованием свободных лоскутов и применение микрохирургической техники. Лоскуты передней брюшной стенки в настоящее время являются методом выбора в реконструктивно-пластической хирургии молочной железы отчасти потому, что позволяют добиться более естественного эстетического результата. Авторы сравнивают различные варианты аутологичных лоскутов, описывают преимущества DIEP-лоскута в сравнении с TRAM-лоскутом. Также особое внимание уделено выбору метода реконструкции молочных желез в зависимости от возраста, конституционных особенностей и наличия факторов риска, таких как курение, сахарный диабет и избыточный ИМТ. Анализируя преимущества реконструкции молочной железы аутологичными лоскутами, авторы делают вывод о более высоком качестве жизни и улучшенных результатах хирургического лечения у таких пациентов, чем у тех, которым была выполнена реконструкция на основе имплантатов. На основании проведенного обзора литературы установлено, что реконструкция молочной железы с помощью аутологичных лоскутов остается областью непрерывного прогресса. В настоящее время исследования в данной сфере направлены в основном на снижение частоты осложнений донорской зоны и усовершенствование методики выделения реципиентных сосудов и сокращение сроков реабилитации после данного метода реконструкции.</p></abstract><trans-abstract xml:lang="en"><p>The article is devoted to the actual topic of breast reconstruction with autologous tissues. The article discusses the key stages in the development of breast reconstructive surgery using free flaps using microsurgical techniques. A flap of the anterior abdominal wall, among other techniques, is the method of choice for breast reconstruction today, also because it allows you to achieve the most "natural" result. The authors compares different variants of autologous flaps, describes the advantages of the DIEP flap in comparison with the TRAM flap. Also, special attention is paid to the choice of breast reconstruction method depending on age, constitutional characteristics and the presence of risk factors such as smoking, diabetes mellitus and excess BMI. Analyzing the advantages of breast reconstruction with autograft flaps, the author concludes that there is a higher quality of life and improved outcomes in these patients than in patients who underwent implant-based reconstruction. Based on the literature review, it was found that breast reconstruction with the help of perforating flaps is still an area of innovation and constant progress: research in this area to date is mainly aimed at reducing the morbidity of the donor area and methods for isolating recipient vessels, shortening the rehabilitation period and developing reproducible reconstruction method.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак молочной железы</kwd><kwd>реконструкция молочной железы</kwd><kwd>DIEP-лоскут</kwd><kwd>TRAM-лоскут</kwd><kwd>перфорантные лоскуты</kwd><kwd>аутологичные лоскуты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>breast cancer</kwd><kwd>breast reconstruction</kwd><kwd>DIEP-flap</kwd><kwd>TRAM-flap</kwd><kwd>perforant flaps</kwd><kwd>autologous flap</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Каприн А.Д., Старинский В.В., Петрова Г.В. 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