保留NAC的改良根治术并一期乳房重建术治疗早期乳腺癌的临床效果  

Clinical efficacy of nipple-areola complex sparing modified radical mastectomy with first-stage breast reconstruction in treatment of early breast cancer

作　　者：孙建伟[1] 刘春生[1] 赖明华[1] 陈昕[1] 杨净渝[1] 牛恒[1] 

机构地区：[1]云南省第一人民医院/昆明理工大学附属医院乳腺甲状腺外科,云南昆明650034

出　　处：《中国普通外科杂志》2015年第11期1530-1535,共6页China Journal of General Surgery

摘　　要：目的:探讨保留乳头乳晕复合体(NAC)的乳腺癌改良根治术并一期乳房重建术治疗早期乳腺癌的安全性及可行性。方法:将2010-2014年乳腺癌患者170例,根据患者意愿分别行保留NAC的乳腺癌改良根治术并一期乳房重建术(观察组,102例),与未保留NAC的皮下乳腺癌改良根治术(对照组,68例)。比较两组术后相关指标、患者对乳房重建的满意度、生活质量情况及随访期间不良事件以及复发、转移发生率。结果:两组术后创面引流时间及引流量无统计学意义差异(均P>0.05)。观察组患者术后满意率(97.06%vs.51.47%)、FACT总评分(150.89±25.34)vs.(100.24±18.47)、生活质量高水平率(83.33%vs.51.47%)均高于对照组(均P<0.05)。两组不良事件发生率、远处转移率及复发率相似,组间无统计学差异(均P>0.05)。结论:保留NAC的改良根治术并一期乳房重建术治疗早期乳腺癌安全、可行,且在术后美学效果、改善患者生活质量方面明显优于未保留NAC的皮下乳腺癌改良根治术。Objective：To investigate the safety and feasibility of the nipple complex（NAC） sparing modified mastectomy with first-stage breast reconstruction in treatment of early breast cancer.Methods：During 2010 to 2014,170 breast cancer patients,according to their own choice,received NAC sparing modified mastectomy with first-stage breast reconstruction（observational group,102 cases）,or modified subcutaneous mastectomy with NAC removal（control group,68 cases）,respectively.The relevant postoperative parameters and postoperative patient＇s satisfaction with breast reconstruction and quality of life as well as the incidence of adverse events,recurrence and metastasis during follow-up of the two groups were compared.Results：The duration and volume of wound drainage showed no significant difference between the two groups（both P〈0.05）;the postoperative patient satisfaction rate（97.06%vs.51.47%）,overall FACT score（150.89±25.34） vs.（100.24±18.47） and high satisfaction rate（83.33%vs.51.47%） in observational group were significantly higher than those in control group（all P〈0.05）;there was no significant difference in incidence of adverse events,local recurrence and distant metastasis between the two groups（all P〈0.05）.Conclusion：NAC sparing modified mastectomy with first-stage breast reconstruction is safe and feasible for early breast cancer,and it is evidently superior to modified subcutaneous mastectomy without NAC preservation with regard to postoperative cosmetic results and improving patient＇s quality of life.

关 键 词：乳腺肿瘤 乳房切除术 改良根治性 乳房成形术 

分 类 号：R737.9[医药卫生—肿瘤]