即刻乳房重建对乳腺癌术后辅助化疗开始时间及并发症的影响  

Impact of immediate breast reconstruction on the onset of adjuvant chemotherapy and on the postoperative complications

作　　者：刘伟色 穆兰[1] 汤小川[1] 余岳[1] 曹旭晨[1] 王欣[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺肿瘤一科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室天津市恶性肿瘤临床医学研究中心乳腺癌防治教育部重点实验室,300060

出　　处：《中华肿瘤杂志》2017年第1期44-47,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金（81472472）

摘　　要：目的探讨即刻乳房重建对术后辅助化疗开始时间（TTC）及术后并发症的影响。方法回顾性分析天津医科大学肿瘤医院2011年1月至2012年12月收治的223例接受化疗的女性乳腺癌患者的临床病理资料。根据患者是否行即刻乳房重建术，将患者分为即刻重建术组（108例）和改良根治术组（115例）。结果即刻重建术组和改良根治术组患者的总并发症发生率分别为49．1％和52．2％．差异无统计学意义（P=0．870）。即刻重建术组和改良根治术组患者二次手术的发生率分别为13．0％和1．7％，差异有统计学意义（P=0．001）。而即刻重建术组和改良根治术组血肿的发生率分别为4．6％和17．4％，差异有统计学意义（P=0．003）。即刻重建术组和改良根治术组患者的中位TTC分别为21d和11d，差异有统计学意义（P〈0．001）。结论即刻重建术组和改良根治术组患者的总并发症发生率无差异，但即刻重建术组患者二次手术的发生率高于改良根治术组，尤其是在化疗开始后。即刻乳房重建术延长乳腺癌患者的TTC。Objective To explore the impact of immediate breast reconstruction on the onset of adjuvant chemotherapy and on the postoperative complications. Methods We retrospectively analyzed the clinical data from female breast cancer patients treated by either modified radical masteetomy with immediate breast reconstruction （IBR） （ n = 108 ） or modified radical masteetomy alone （n = 115 ） , followed by adjuvant chemotherapy at our department between January 2011 and December 2012. Results There was no significant difference in the overall complication rates between the IBR group and modified radical mastectomy group （ 49.1% vs. 52.2%, P = 0.87）. However, more secondary surgery was applied in the IBR group than the modified radical mastectomy group （ 13.0% vs. 1.7%, P= 0.001 ）. However, the incidence of hematoma in the modified radical masteetomy group was significantly higher than the IBR group （ 17.4% vs. 4.6%, P= 0.003）. There was a significant difference in the onset of adjuvant chemotherapy between the IBR group and modified radical mastectomy group （21 days vs. 1 l days, P〈 0.001 ）. Conclusions Immediate breast reconstruction has no significant impact on the overall complication rate, but increases the incidence of secondary surgery, especially after the initiation of chemotherapy. In addition, it slightly delays adjuvant chemotherapy in the patients.

关 键 词：乳腺肿瘤 乳房成形术 即刻乳房重建 肿瘤辅助疗法 并发症 

分 类 号：R737.9[医药卫生—肿瘤]