Ⅰ期乳房重建中扩张器的应用  

The application of tissue expander in immediate breast reconstruction

作　　者：王振宇[1] 姜晓曼 杜彤华[1] 张研[1] Wang Zhenyu;Jiang Xiaoman;Du Tonghua;Zhang Yan(Department of Breast Surgery,the Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院乳腺外科,长春130041

出　　处：《中华内分泌外科杂志》2019年第2期93-96,共4页Chinese Journal of Endocrine Surgery

基　　金：吉林省科技发展计划重点研发项目(20180201054YY).

摘　　要：目的探讨乳腺癌行保留乳头的腺体切除术(nipple sparing mastectomy, NSM)后Ⅰ期扩张器乳房重建的手术要点、术后并发症及乳房外形满意度。方法对2014年7月至2018年4月收治的23例乳腺癌患者(其中2例为双侧)共25侧行NSM加即刻扩张器植入进行乳房重建手术的临床资料进行回顾性分析。结果25侧行NSM后加即刻扩张器植入的手术,并发症12%,其中包括:1例血清肿,1例术后出现轻度乳头坏死及1例术后出现乳头局部偏移畸形。中位随访12个月未出现Ⅲ度及Ⅳ度的包膜挛缩,外形的满意度应用Harvard评分系统,医生评分:fair(2例;8%),good(2例;8%),excellent(21例;84%);患者评分:good(4例;16%),excellent(21例;84%)。无局部复发的病例出现。结论经外侧切口NSM术后应用Ⅰ期扩张器乳房重建手术操作简便,并发症较少,术后可获得较满意的乳房外形。Objective To investigate the surgical procedure, complication and cosmetic effects of tissue expander in immediate breast reconstruction after nipple sparing mastectomy (NSM). Methods From Jul. 2014 to Apr. 2018, the clinical data of 23 breast cancer patients (two patients were bilateral) undergoing NSM and expander immediate breast reconstruction were analyzed retrospectively. Results All of the 25 procedures were NSM plus expander based immediate breast reconstruction. The overall complication rate was 12%, including: one seroma, one mild nipple necrosis and one nipple malposition. The median follow up period was 12 months, no grade Ⅲ or Ⅳ contractures were found. Appearance satisfaction was applied to the Harvard scoring system, doctor score: fair (2 cases;8%), good (2 cases;8%), excellent (21 cases;84%);patient score: good (4 cases;16%), excellent (21 cases;84%). No local recurrence was observed. Conclusion NSM with lateral incision and immediate reconstruction was found to be technically feasible and associated with few complications and satisfactory esthetic outcomes.

关 键 词：乳腺癌 扩张器 乳房重建 并发症 

分 类 号：R737.9[医药卫生—肿瘤]