保留乳头乳晕的乳腺癌改良根治术后即刻假体乳房再造的效果  

Clinical efficacy of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer

作　　者：屈洪波[1] 朱芳 胡雄强[1] 谢海清[1] 何雄斌[1] 严婕[1] 何建怀 宋达疆[3] 李赞[3] Qu Hongbo;Zhu Fang;Hu Xiongqiang;Xie Haiqing;He Xiongbin;Yan Jie;He Jianhuai;Song Dajiang;Li Zan(Department of Breast and Thyroid Surgery,the First People's Hospital of Chenzhou,Chenzhou 423000,China;Department of Breast Health Center,the First People's Hospital of Chenzhou(South Hospital),Chenzhou 423000,China;Department of Plastic Surgical Oncology,Hunan Province Cancer Hospital,Changsha 410008,China)

机构地区：[1]湖南省郴州市第一人民医院乳腺甲状腺外科,423000 [2]湖南省郴州市第一人民医院(南院)乳房保健中心,423000 [3]湖南省肿瘤医院乳腺肿瘤整形外科,长沙410000

出　　处：《中华医学美学美容杂志》2021年第1期38-41,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨硅胶假体在保留乳头乳晕的乳腺癌改良根治术后即刻乳房再造的效果。方法2016年1月至2018年1月,湖南省郴州市第一人民医院乳腺甲状腺外科收治30例女性乳腺癌患者,年龄30~55岁,平均42岁;分为两组。观察组15例采用保留乳头乳晕的乳腺癌改良根治术联合即刻假体乳房再造,对照组15例仅行乳腺癌改良根治术。比较两组患者手术各指标及术后并发症之间差异及评价术后美容效果。结果观察组15例患者成功完成假体乳房再造。观察组在手术时间、引流管留置时间均较对照组增加,差异有统计学意义(t值分别为118.8、23.9,均P<0.05)。两组在术后皮瓣缺血坏死、皮下血肿、术区感染及切口裂开等并发症比较,差异无统计学意义(均P>0.05)。观察组术后并发症发生率40.0%,与对照组(20.0%)比较,差异无统计学意义(P>0.05);术后美容效果评价显示再造乳房外形饱满,与对侧基本对称,优良率83.3%,患者对乳房外观比较满意。所有患者术后随访12~36个月,中位数24个月,均未见局部复发及远处转移。结论在保留乳头乳晕的乳腺癌改良根治术同时,即刻应用硅胶假体行乳房再造具有创伤小、术后恢复快及美容效果好,值得临床应用。Objective To explore clinical application value of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer.Methods The clinical data of 30 breast cancer patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy from January 2016 to January 2018 were collected.In the observation group,15 patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy.In the control group,15 patients underwent conventional modified radical mastectomy only.The differences of operation indicator and postoperative complications between the two groups were compared,and the postoperative cosmetic effects were evaluated.Results The patients successfully completed prosthetic breast reconstruction in the observation group.The surgical time and indwelling time of the drainage tube in the observation group were both increased compared with the control group,and the difference was statistically significant(t=118.8 and t=23.9,P<0.05).There were no statistically significant differences between the two groups in the complications of postoperative flap necrosis,subcutaneous hematoma,intraoperative infection and incision dehiscence(P>0.05).The total complications rate of the observation group was 40%,compared with the control group(20%),there were not statistically significant differences(P>0.05).The postoperative aesthetic effect evaluation showed that the reconstructed breast was full in shape and basically symmetrical to the contralateral side,with an excellent and good rate of 83.3%.The patients were satisfied with the appearance of the breast.All patients were followed up for 12 to 36 months with the average time of 24 months,and local recurrence and distant metastasis were not observed.Conclusions In the modified radical mastectomy for breast cancer with preserved nipple and areola,the immediate application of silicone prosthesis for breast reconstruction has the adva

关 键 词：乳腺肿瘤 乳房成形术 硅胶假体 乳房再造 乳腺癌改良根治术 

分 类 号：R737.9[医药卫生—肿瘤]