乳腔镜辅助乳腺癌保乳手术后自体脂肪颗粒注射成形术近期疗效  

Mastoscopic breast-conserving surgery and breast reconstruction with autologous fat transplantation for breast cancer

作　　者：刘宝胤[1] 骆成玉[1] 陈忠存[2] Liu Baoyin Luo Chengyu Chen Zhongcun(Department of General Surgery, Fuxing Hospital, Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学附属复兴医院普外科,100038 [2]首都医科大学附属复兴医院整形外科,100038

出　　处：《北京医学》2016年第10期1044-1046,共3页Beijing Medical Journal

摘　　要：目的 探讨乳腔镜保乳手术后自体脂肪颗粒注射成形的手术方法、可行性及疗效.方法 Ⅰ、Ⅱ期乳腺癌女性患者13例采用乳腔镜辅助保乳手术后自体脂肪颗粒注射成形治疗.采用抽吸臀部或大腿部的脂肪,提取纯净脂肪颗粒,注射到患侧乳腺后间隙、胸大肌后间隙及皮下.结果 切除腺体组织切缘未见癌残留.按TNM分期：T1N0M0期5例,T2N0M0期3例,T1N1M0期2例,T2N1M03例.术后病理证实12例为浸润性导管癌,1例为小叶癌.13例均无皮下气肿、乳头及皮肤局部坏死情况.均在术后7～10 d拔除引流管.术后3个月3例出现脂肪硬结,经穿刺诊断为脂肪液化.13例均获随访,随访时间6～13个月,中位时间9个月,均无局部复发及远处转移,无患侧上肢水肿及功能障碍.术后外观评价：优10例,良3例,优良率达100％.结论 保乳手术治疗Ⅰ、Ⅱ期乳腺癌能减少创伤,自体脂肪颗粒填充成形手术简便、创伤小、出血少,能够提高乳房美容满意度,且近期安全性好,值得进一步推广.Objective To investigate the surgical skill, feasibility and cosmetic results of mastoscopic breastconserving surgery and breast reconstruction with autologous fat transplantation. Methods From July 2014 to Apirl 2015, a total of 13 cases with stage Ⅰ and Ⅱ breast cancer received mastoscopic breast-conserving surgery and breast reconstruction with autologous fat transplantation in our hospital. Autologous fat was obtained from patient＇s buttocks or thighs, and was extracted and purified. The purified fat were injected into each breast. Results All of the 13 cases underwent mastoscopic breast-conserving surgery and breast reconstruction with autologous fat transplantation successfully. No residual was found in frozen sections. According to TNM classification, 5 cases were T1N0M0, 3 cases were T2N0M0,2 cases were T1N1M0,3 cases were T2N1M0.Infiltrating duct carcinoma was confirmed in 12 cases and lobular carcinoma in 1 case by postoperative pathological exam. There was no subcutaneous emphysema, nipple necrosis or skin necrosis in all cases. Subcutaneous hydrops was found in 3 cases after operation and cured by puncture, suction and press dressing. All 13 patients were followed up for 6 to 13 months without metastasis or recurrence. No edema of the involved upper extremity and dysfunction occurred. The outcome revealed excellence in 10 cases, good in 3 cases, and the rate of satisfactory cosmetic result was 100%. Conclusion The breast conserving surgery can reduce the trauma in patients with stage Ⅰ and Ⅱ breast cancer. Breast reconstruction with autologous fat transplantation is convenient to perform and it can improve satisfaction toward breast cosmetic result. This surgery is safety in short term, and worth to be spreaded.

关 键 词：乳腔镜 保乳手术 Ⅰ、Ⅱ期乳腺癌 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]