乳腺癌保留乳头乳晕乳腺切除即刻假体重建随访分析  

作　　者：徐海滨[1] 杨欧欧[1] 胡祖健[1] 苏昆仑[1] 何俊玲[1] 罗华[1] 

机构地区：[1]杭州市中医院乳腺外科,310007

出　　处：《浙江临床医学》2016年第10期1779-1781,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：观察早期乳腺癌保留乳头乳腺切除即刻假体重建手术肿瘤学安全性及手术相关并发症。方法回顾分析2007年10月至2012年10月51例早期乳腺癌患者行保留乳头乳晕乳腺切除（NSM）即刻乳房假体重建术（IBR）。结果所有患者均术后前2年随访1次/3个月，2年后随访1次/0.5~1年，随访时间36~96个月，中位随访时间70个月。2例（3.9%）出现局部复发和远处转移，无乳头乳晕部位复发病例。3例（5.9%）发生完全或部分乳头坏死，1例（2%）出现局部皮肤坏死（3cm×2cm）假体暴露经换药3个月后再次手术取出假体，12例（23.5%）切口延期愈合经换药1~2个月切口愈合，7例（13.7%）皮下及假体周围积液，2例（3.9%）感染经抗感染治疗好转。未发生包囊挛缩和假体破裂，乳腺外观主观评价优良率达86.3%。结论早期乳腺癌行保留乳头乳晕乳腺切除即刻假体重建在肿瘤学上是安全的，同时具有术后恢复快、并发症少、不增加局部复发风险，患者对外观满意度高的优点。ObjectiveThe explore the safety and complications of the nipple-sparing mastectomy with immediate Implant breast reconstructive for early breast cancer .Methods Retrospective analysis were carried out on 51 cases of patients with early stage breast cancer undergoing nipple-sparing mastectomy（NSM）and immediate breast reconstruction（IBR）at our hospital from October 2007 to October 2012.Results All patients were followed-up once every 3 months to 6 months before 2 years and 6 months to 1 year follow-up 2 years later,follow-up time was 36-96 months, median follow-up time was 70 months. 2 cases（3.9%）had local recurrence and distant metastases,no recurrence of the nipple areola area. 3 cases （5.9%）occurred wholly or partly nipple necrosis,and 1（2%）had local skin necrosis（3cm×2cm）prosthesis exposure by dressing 3 months later surgical removal of the prosthesis again,12 cases（23.5%）delayed healing incision by dressing 1-2 months wound healing,7 cases（13.7%） peripheral and subcutaneous implants effusion,2 cases（3.9%）was infected and was improved after anti-infection treatment. Encapsulation contracture and implantrupture did not occur,the excellent rate of appearance of the subjective evaluation of breast was 86.3%.Conclusions The nipple-sparing mastectomy with immediate Implant breast reconstructive for early breast cancer is safe,with a rapid recovery,fewer complications,without increasing the risk of local recurrence,and has the advantages of patients’ high satisfaction with the postoperative appearance.

关 键 词：乳腺癌 保留乳头乳晕乳腺切除 即刻假体重建 

分 类 号：R737.9[医药卫生—肿瘤]