单切口环乳晕入路保留乳头乳晕乳腺癌改良根治术联合同期乳腺扩张器植入术的应用分析  

Specific Original Articles on Breast CancerAnalysis of single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation

作　　者：王常珺[1] 姚儒[1] 周易冬[1] 茅枫[1] 关竞红[1] 林燕[1] 王学晶[1] 张晓辉[1] 张燕娜[1] 沈松杰[1] 钟颖[1] 潘博[1] 徐雅莉[1] 费凯伦 孙强[1] 

机构地区：[1]中国医学科学院北京协和医院乳腺外科,北京100730

出　　处：《中华内分泌外科杂志》2017年第2期92-96,共5页Chinese Journal of Endocrine Surgery

基　　金：“十二五”国家科技支撑计划重点项目（2014BA108B03）;北京市自然科学基金项目（7164292）;北京协和医院-加州大学旧金山分校联合转化医学研究基金（PUMCH-UCSF RT201504）

摘　　要：目的探讨单切口环乳晕入路行保留乳头乳晕乳腺癌改良根治术联合同期乳腺扩张器植入术的肿瘤根治性、手术安全性及美学效果。方法纳入2014年1月至2015年12月北京协和医院乳腺外科收治经环乳晕单切口及乳腺、腋窝双切口行乳腺癌手术治疗及同期扩张器植入患者30例。比较单切口环乳晕入路和双切口入路组在临床病理特征、平均住院时间、术后并发症及综合美学效果的差异。结果单切口环乳晕入路组共纳入19例，双切口入路组共纳入11例，2组在手术时间（P=0.093）和平均住院时间（P=0.339）差异均无统计学意义。术后随访时间平均19.1（8~31）个月，2组均无一例伤口积液及患侧上肢淋巴水肿，2组在乳头乳晕区感觉评分（P=0.973）、双乳对称性评分（P=0.650）及综合美学效果评分（P=0.483）差异均无统计学意义。结论单切口环乳晕入路行保留乳头乳晕乳腺癌改良根治联合同期扩张器植入术具有较高的手术安全性及术后美观效果，同时减少患者创伤，可作为乳腺癌手术优选方案之一。ObjectiveTo explore the safety and cosmetic effect of nipple-sparing modified radical mastectomy and immediate tissue expander implantation with single circumaereolar incision.Methods30 patients were enrolled in Peking Union Medical College Hospital between Jan. 2014 and Dec. 2015. All the patients were categorized according to surgical incision （single circumaereolar incision group vs double incisions group） . Data on clinicopathological parameters, average hospital stay,complications and overall cosmetic effect were retrospectively collected. Data was performed with Chi-square test, Fisher exact test and t-test. Statistical significance was defined as P〈0.05.Results19 patients were enrolled in single circumaereolar incision group, and 11 patients in double incisions group. There was no significant difference for operation duration （P=0.093） and average hospital stay （P=0.339） . After follow-up for 19.1 months, ranging from 8 to 31 months, no patients developed seroma or arm lymphedema. There was no statistical significance between the two groups in terms of sensation in nipple-aereolar area （P=0.973） , bilateral symmetry （P=0.650） and overall cosmesis （P=0.483）.Conclusionsingle circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness, reliable oncological safety and decent cosmetic effect.

关 键 词：环乳晕入路 保留乳头乳晕乳腺癌改良根治术 乳腺癌改良根治术 扩张器植入 乳房重建 

分 类 号：R737.9[医药卫生—肿瘤]