残留腺体转位整形法在乳腺癌保乳手术中的应用  

Breast reshaping with displacement of residual gland following breast conserving surgery

作　　者：周围[1] 王泽强[1] 郭琼[1] 胡壹[1] 廖妮[1] 

机构地区：[1]湖南省株洲市一医院乳腺外科,湖南株洲412000

出　　处：《中国普通外科杂志》2012年第11期1338-1341,共4页China Journal of General Surgery

摘　　要：目的:探讨乳腺癌保乳手术中采用残留腺体转位整形法应用的可行性,并评估其美学效果。方法:对2009年10月—2011年11月收治的47例肿瘤直径≤3 cm的乳腺癌患者行保乳手术,其中36例采用残留腺体转位整形法(观察组),11例仅直接缝合皮肤(对照组),分别评估两组患者的术后及放疗后的美学效果。结果:全部患者随访9～33个月,中位随访时间21个月,无1例复发及转移。术后3个月,观察组与对照组达到优或良美学效果的分别为31例(86.1%)和8例(72.7%),两组差异无统计学意义(P>0.05);放疗后3个月,观察组与对照组在放疗后达到优或良美学效果的分别为30例(83.3%)和6例(54.5%),观察组的美学效果优于对照组,差异有统计学意义(χ2=3.895,P<0.05)。结论:对于肿瘤直径≤3 cm的乳腺癌患者,采用残留腺体转位整形法是一种简单、有效、创伤小、术后乳房美学效果满意的方法。Objective： To investigate the feasibility and assess the cosmetic effect of mammaplasty with displacement of residual glandular tissue following breast conserving surgery. Methods： Breast conserving surgery was performed in 47 patients whose lesion size was less than 3 cm and admitted between October 2009 and November 2011. Of the patients, 36 cases received oncoplastic volume displacement （observation group） and 11 cases had only direct skin closure without treatment of the post- resection defect （control group） following breast conserving surgery. The cosmetic results of the two groups were evaluated after operation and radiotherapy~ respectively. Results： All patients were followed up for 9-33 months with median follow-up of 21 months, and no recurrence or metastasis occurred in any of the patients. Three months after surgery,the excellent or good cosmetic outcome was achieved in 31 cases （86.1%） in observation group and 8 cases （72.7%） in control group respectively, and there was no statistical difference between the two groups （P〉0.05）; three months after radiotherapy, the cosmetic excellent or good result was obtained in 30 cases （83.3%） in observation group and 6 cases （54.5%） in control group respectively, where the cosmetic result in observation group was better than that in control group and the difference between the two groups reached statistical significance （~=3.895, P〈0.05）. Conclusion： For breast cancer patients with tumor diameter less than 3 cm, volume displacement oncoplastic surgery has the advantages of being simple, effective, and minimally invasive as well as having better postoperative cosmetic outcome.

关 键 词：乳腺肿瘤 乳房切除术 区段 外科 整形 

分 类 号：R737.9[医药卫生—肿瘤]