内窥镜辅助胸大肌筋膜下乳房假体置入的效果初探  

Endoscopy assisted sub-pectoral fascial breast augmentation and reconstruction:preliminary clinical results

作　　者：修骋 穆籣 陈茹[2] 汤鹏[3] 钟晓捷 刘侠 宋景涌 Xiu Cheng;Mu Lan;Chen Ru;Tang Peng;Zhong Xiaojie;Liu Xia;Song Jingyong(Department of Head and Neck Surgery,Cancer Hospital Affiliated to Hainan Medical College,Hainan Cancer Hospital,Hciikou 573100,China;Department oj Breast Surgery and Plastic Surgry,Hainan Hospital,Haikou 570311,China;Department of Breast Surgery,Cancer Hospital Affiliated to Hainan Medical College Hainan Cancer Hospital,Haikou 573100,China)

机构地区：[1]海南省肿瘤医院海南医学院附属肿瘤医院头颈外科,海口573100 [2]海南省人民医院海南医学院附属海南医院乳腺外科/整形外科,海口570311 [3]海南省肿瘤医院(海南医学院附属肿瘤医院乳腺外科),海口573100

出　　处：《中华医学美学美容杂志》2021年第6期489-491,共3页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：海南省科技攻关项目(ZDYF2020130)。

摘　　要：目的探讨胸大肌筋膜下层次植入乳房假体在隆乳和乳房再造中的初步临床效果。方法2019年10月至2021年11月.海南省人民医院及海南医学院附属肿瘤医院等单位同一整形外科医师和乳腺外科治疗小乳症、乳房萎缩、乳房预防性切除、单侧乳房缺损对侧乳房萎缩女性患者6例(10侧),年龄20〜35岁,中位年龄29岁。均用胸大肌筋膜下层次植入乳房假体,均用内窥镜辅助。结果10侧乳房假体植入体积180〜300 ml,平均200 ml。术后早期患者疼痛轻微.引流量较少。随访6〜21个月,平均9个月;未见术后假体移位、双泡畸形等并发症。随时间推移效果更自然,无需二次手术。结论内窥镜辅助下胸大肌筋膜下乳房假体植入,避免胸大肌损伤、剥离范围精准、止血彻底、效果可靠,对适应证患者临床效果肯定,值得临床应用。Objective To investigate the preliminary effects of sub-pectoral fascial breast augmentation and reconstruction.Methods Six patients(10 breasts)of mammary dysplasia,mastatro-phy,prophylactic mastectomy,unilateral breast defect with contralateral mastatrophy were included in the study from Oct.2019 to July 2021.The mean patient age was 29 years(range,20 to 35 years).All the textured and smooth cohesive gel implants were inserted under pectoralis major fascia by endoscopic-assisted,incisions were including axillary,around areola and inferior mammary fold approaches.The prophylactic mastectomy cases were performed nipple sparing mastectomy and sub-pectoral fascial breast restoration with implants.The fat and fascia tissue were well reserved to give a satisfying coverage of the appropriate implant.Negative pressure drainage and moulding dressing were used after the surgery.Results Ten breast augmentation and restoration with a mean implant size of 200 cc(range,180-300 cc).Less immediate postoperative pain and bleeding were reported.Patients were followed up for an average of 10 months(range,6 to 21 months).There were no cases of major malpositions,double-bubble and bottom out symptoms.The overall outcome was with better symmetry and satisfaction with time passed by*and no secondary surgical procedures needed.Conclusions Primary and satisfactory results have been obtained in subfascial breast augmentation and restoration for indications.With the endoscopic-assisted accurate pectoral fascial dissection,and well reserved soft tissue coverage,this technique could avoid the pectoralis major muscle ablation and keep the advantages of sub-glandular plane.

关 键 词：内窥镜 胸大肌筋膜 假体 隆乳术 乳房再造 

分 类 号：R655.8[医药卫生—外科学]