目的 比较部分背阔肌（partial latissimus dorsi musculocutaneous， pLD-MC）皮瓣与胸外侧动脉穿支皮瓣（lateral thoracic artery perforator， LTAP）在容积替代保乳手术中的临床应用效果。 方法 本研究纳入2020年7月至2024年7月于广西医科大学附属肿瘤医院乳腺外科接受容积替代保乳手术的患者共49例，根据所采用的皮瓣类型分为LTAP组（n = 29）和pLD-MC组（n = 20）。比较两组术后并发症发生率、手术时间、BREAST-Q评分，并采用Log-rank检验进行无病生存期（disease-free survival， DFS）和总生存期（overall survival， OS）分析。 结果 LTAP组手术时间显著短于pLD-MC组（P < 0.05）。术后BREAST-Q评分显示，LTAP组在躯体健康评分及手术效果评价评分方面均高于pLD-MC组（P < 0.05）。LTAP组并发症发生率为3.4%（1/29），pLD-MC组为10.0%（2/20），两组间差异无统计学意义（P > 0.05）。DFS及OS分析显示，两组间差异无统计学意义（P > 0.05）。 结论 在肿瘤位于乳房外象限、LTAP解剖可见且侧胸壁可提供足够组织量的前提下，LTAP皮瓣相较于pLD-MC皮瓣手术时间更短，术后躯体健康评分更优，且安全性相当，可作为优先选择的容积替代保乳方式。

Objective To compare the clinical outcomes of the partial latissimus dorsi musculocutaneous （pLD-MC） flap and the lateral thoracic artery perforator （LTAP） flap in volume replacement breast-conserving surgery. Methods A total of 49 patients who underwent volume replacement breast-conserving surgery in the Department of Breast Surgery at the Affiliated Tumor Hospital of Guangxi Medical University between July 2020 and July 2024 were included in this study. Based on the type of flap used， the patients were divided into an LTAP group （n=29） and a pLD-MC group （n=20）. Postoperative complication rates， operative time， and BREAST-Q scores were compared between the two groups. Disease-free survival （DFS） and overall survival （OS） was analyzed using the Log-rank test. Results The operative time in the LTAP group was significantly shorter than that in the pLD-MC group （P < 0.05）. Postoperative BREAST-Q scores showed that the LTAP group achieved significantly higher scores in physical well-being and satisfaction with surgical outcomes compared to the pLD-MC group （P < 0.05）. The complication rate was 3.4% （1/29） in the LTAP group and 10.0% （2/20） in the pLD-MC group， with no statistically significant difference between the two groups （P > 0.05）. Analysis of DFS and OS also revealed no statistically significant differences between the groups （P > 0.05）. Conclusion For tumors located in the outer quadrant of the breast， when the lateral thoracic artery perforator is anatomically identifiable and the lateral chest wall can provide sufficient tissue volume， the LTAP flap is associated with a shorter operative time and superior physical well-being scores postoperatively， while maintaining comparable safety profiles to the pLD-MC flap. Therefore， the LTAP flap may be considered the preferred option for volume replacement in breast-conserving surgery.