扩张法假体置入乳房再造术  

Breast reconstruction with a subpectoral silicone tissue expander

作　　者：单秀英[1] 王彪[1] 汪怡[1] 王美水[1] 郑厚兵[1] 刘照亮[1] 

机构地区：[1]福建医科大学附属第一医院整形外科,福建福州350005

出　　处：《中国美容医学》2015年第12期4-8,共5页Chinese Journal of Aesthetic Medicine

基　　金：国家临床重点专科建设项目经费资助;国家卫生和计划生育委员会科研基金--福建省卫生教育联合攻关计划项目(WKJFJ03)

摘　　要：目的：探讨皮肤软组织扩张后假体置入乳房再造术在乳癌术后乳房再造中的临床应用。方法：一期手术在肿胀麻醉基础上钝性分离胸大肌后间隙，范围如术前设计大小，将250～350ml容积的圆形皮肤软组织扩张器置于胸大肌深面，术中依据皮肤张力大小注水80～150ml，术后定期注水，依据对侧乳房体积超量注水30%～50%，维持3个月以上。二期手术时取出扩张器，置入合适容积的乳房假体，尽量达到双侧乳房形态的对称。结果：2010年-2013年，笔者所在科室采用扩张后假体置入法再造乳房21例，已完成二期手术19例。经过1～4年的随访，19侧再造乳房外形较满意，大小、位置与健侧乳房基本一致。结论：本法再造乳房大小合适，形态自然，位置对称，无附加供区，不增加额外瘢痕，操作简单，是一种较为理想的乳房再造术。Objective To explore the clinical application of post-expansion prosthesis implantation in post-mastectomy breast reconstructions. Methods In the 1st stage of surgery, bluntly dissect the subpectoral space and insert a 250-300ml round-shaped tissue expander under local swelling anesthesia.Augment the tissue expander intra-operatively with 80-150ml of saline with careful concern to the tension of local skin.Regularly inject the saline until the expander is exceeding 30%-50%the volume of the contralateral breast and maintain the volume for over 3 months.During the 2nd stage of surgery,replace the tissue expander with an appropriate prosthesis so that the symmetry of breasts, to a large extent,can be achieved. Results From 2010 to 2013,our department has accomplished 21 cases of implant-based breast reconstruction post tissue expansion,among which 19 cases have completed both stages of surgeries.The follow-up periods range from 1 to 4 years,and the 19 reconstructed breasts have all achieved satisfactory appearances and symmetry with the contralateral breast,in terms of size and position. Conclusions With its simple techniques,the procedure leads to natural and symmetrical appearance of breasts,concerning volume and position. Moreover,there is no additional donor site and extra scar involved.The post- expansion prosthesis implantation is an ideal option for breast reconstruction.

关 键 词：组织扩张术 乳房再造术 乳房假体 皮肤软组织扩张器 乳腺癌 

分 类 号：R655.8[医药卫生—外科学]