腔镜辅助两切口保留乳头乳晕乳腺癌术后即刻背阔肌乳房重建的临床研究  

A clinical study of breast reconstruction of latissimus dorsi immediately after the breast cancer surgery of retaining papilla and areola by two incisions assisted by endoscopy

作　　者：施勇[1] 温涛[1] 黄凯明[1] 王科[1] 郑晶燕[1] 

机构地区：[1]温州医科大学附属第六医院丽水市人民医院乳腺疾病诊治中心/甲状腺乳腺外科,浙江丽水323000

出　　处：《中国现代医生》2017年第5期37-40,44,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2012KYA193;2013KYB299);浙江省丽水市科技计划项目(2010JYZB24;20110416);浙江省丽水市高层次人才培养资助项目(2014RC11)

摘　　要：目的探讨采用两切口在腔镜辅助下行保留乳头乳晕复合体的改良乳腺癌根治术后即刻应用背阔肌进行乳房重建的可行性与美容效果。方法 2011年9月~2014年9月,对18例患者在腔镜辅助下进行乳腺癌行保留乳头乳晕的乳腺癌改良根治术,术后即刻应用背阔肌肌瓣进行缺损充填乳房重建,术后评价其重建效果。结果1S例患者手术成功,恢复良好,术后7例皮下积液,3例出现血清肿,2例出现部分乳头坏死、均经处理后愈合;形态良好,16例患者评价为优,非常满意,2例评价为良、较为满意。患者均获随访3~60个月、所有患者均生存、均无远处转移及局部复发。结论在腔镜辅助下采用两切口进行保留乳头乳晕复合体的乳腺癌改良根治术后同侧背阔肌肌瓣即刻乳房重建,手术安全,技术可行,术后切口隐蔽,可以获得非常好的的乳房形态与美容效果。Objective To investigate the feasibility and cosmetic effect of breast reconstruction with latissimus dorsi immediately after modified radical mastectomy with two incisions for retaining papilla and areola under endoscopy. Methods A total of 18 patients were given modified radical mastectomy of breast cancer for retaining papilla and areola under endoscopy from September 2011 to September 2014. Immediately after the surgery, latissimus dorsi muscle flap was applied for defect filling and breast reconstruction. The reconstruction effect was evaluated after the surgery. Re- suits A total of 18 patients were given successful operation and recovered well. After the surgery, there were 7 cases of subcutaneous effusion, 3 cases of serum swelling, 2 cases of partial nipple necrosis, which were all healed after treat- ment; the shape is good, and 16 patients were evaluated as excellent, with high satisfaction. 2 cases were evaluated as favorable, with moderately high satisfaction. Patients were followed up for 3 to 60 months, and all patients survived, without distant metastasis and local recurrence. Conclusion The breast reconstruction of the ipsilateral latissimus dorsi muscle flap immediately after modified breast cancer mastectomy with two incisions for retaining the complexus of papilla and areola under endoscopy is safe, the technique is feasible, and postoperative incision is concealed, which is able to obtain a very good breast shape and cosmetic effect.

关 键 词：乳腺癌 保留乳头乳晕复合体 背阔肌肌皮瓣 乳房重建 切口 腔镜 

分 类 号：R737.9[医药卫生—肿瘤]