乳腺癌改良根治术后即刻乳房再造不同方法的临床应用  

Clinical experiences of immediate breast reconstruction using different methods after modified radical operation of breast cancer

作　　者：杨庄青[1] 汤学良[1] 邹天宁[1] 陈德滇[1] 张勇[1] 聂建云[1] 张季[1] 郑凯[1] 

机构地区：[1]昆明医学院第三附属医院(云南省肿瘤医院)乳腺科,云南昆明650118

出　　处：《现代肿瘤医学》2009年第9期1692-1695,共4页Journal of Modern Oncology

摘　　要：目的:探讨乳腺癌改良根治术后即刻乳房再造不同方法的适应证、手术方法及优缺点。方法:本组37例乳腺癌患者,分别采用横形腹直肌肌皮瓣带蒂转移、腹壁下动脉穿支皮瓣吻合血管游离移植、背阔肌肌皮瓣带蒂转移、单纯乳房假体置入以及不同方法相结合进行术后即刻乳房再造。结果:除2例单纯TRAM皮瓣患者近腋窝皮瓣局部坏死,1例TRAM+DIEP联合皮瓣患者下腹正中局部皮瓣脂肪液化外,余34例皮瓣全部成活,形态满意。随访5个月-10年,无腹部薄弱或腹壁疝等并发症,患者生活质量均得到提高。结论:乳腺癌术后即刻再造安全可行,不同的方法各有优缺点,应根据患者具体情况选择适合患者本人的方法进行乳房再造。Objective：To investigate the indications,surgical methods,advantages and effects of different methods for breast reconstruction following modified radical operation. Methods ： Thirty seven cases of immediate breast reconstruction were performed by using different methods, such as pedicled TRAM （ transverse abdominal myocutaneous flap） ,free DIEP （ deep inferior epigastric perforator flap） ,latissimus dorsi musculocutaneous flap,full -size implant or combining one or two of these methods. Results ： Except 2 pedicled TRAM flap failed due to partial flap necrosis, 1 case of TRAM and DIEP combining flap suffered from fat necrosis, all the other flaps survived completely with satisfied shape. No recurrence cases or abdomen hernia happened within 5 months to 10 years follow -up,the patients＇life quality was improved. Conclusion：Immediate breast reconstruction after surgical breast treatment is safe and effective; It can cure patients both physically and psychologically. Certain method should be chosen for patients according to personal situation.

关 键 词：乳腺癌 根治术 即刻乳房再造 

分 类 号：R737.9[医药卫生—肿瘤]