保留乳头乳晕的乳腺癌改良根治术后即刻扩大背阔肌肌皮瓣乳房再造61例  

Immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipple-sparing modified radical mastectomy in 61 cases

作　　者：黄佳鹏[1] 莫军扬[1] 庄亚强[1] 黄平[1] 

机构地区：[1]广西壮族自治区柳州市人民医院乳腺外科,545006

出　　处：《肿瘤研究与临床》2015年第3期183-186,189,共5页Cancer Research and Clinic

基　　金：柳州市科学研究与技术开发计划（2014J030408）

摘　　要：目的 探讨保留乳头乳晕的乳腺癌改良根治术后即刻扩大背阔肌肌皮瓣乳房再造的方法及效果.方法 对2008年1月至2014年7月收治的61例乳腺癌患者行保留乳头乳晕的乳腺癌改良根治术,并即刻采用扩大背阔肌肌皮瓣行乳房再造.结果 61例乳房再造手术均取得成功,未发生皮瓣坏死及严重并发症.随访时间12～78个月,未出现局部复发,远处转移4例,死亡1例,乳房形态外观评定“优良”率达到93.4％.结论 保留乳头乳晕的乳腺癌改良根治术后即刻扩大背阔肌肌皮瓣乳房再造安全可靠,易于掌握,严重并发症少.再造乳房形态自然美观,提高了患者生存质量,不影响术后辅助治疗,国内大部分患者无需借助假体完成,值得推广.Objective To investigate the surgical method and therapeutic effects of immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipple-sparing mastectomy.Methods From January 2008 to July 2014,61 patients with breast cancer were given immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipple-sparing mastectomy.Results All of the 61 patients obtained successful breast reconstruction without flap necrosis and serious complications.Followed-up from 12 to 78 months,all patients were no local recurrence,but distant metastasis was occurred in 4 cases and death in 1 case.The morphology of reconstructed breast was excellent in 93.4 % （57/61） cases.Conclusion Immediate breast reconstruction with extended latissimus dorsi myocutaneous flap after nipplesparing mastectomy is safe,easy to master and has few serious complications.The reconstructed breast has a natural and beautiful appearance and improves the quality of life.It does not affect postoperative adjuvant therapy.Most Chinese patients can obtain breast reconstruction without implant.This method is worth to spread.

关 键 词：乳腺肿瘤 乳房再造 扩大背阔肌肌皮瓣 保留乳头乳晕的乳房切除术 

分 类 号：R737.9[医药卫生—肿瘤]