乳腺癌保留乳头乳晕腺体全切即刻背阔肌带蒂肌皮瓣转移乳房重建术的临床疗效评价  

Clinical efficacy of breast reconstruction with immediate latissimus dorsi pedicled musculocutaneous flap translocation after nipple-areola-preserving and total mammary gland resection for breast cancer

作　　者：杨宇扬 李艰娟 金丽涛 黄华英 张思明 YANG Yuyang;LI Jianjuan;JIN Litao;HUANG Huaying;ZHANG Siming(Meizhou People’s Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《现代医院》2022年第5期811-814,共4页Modern Hospitals

基　　金：梅州市科技计划项目(2018B015)。

摘　　要：目的探索乳腺癌患者接受全乳腺体切除即刻背阔肌带蒂肌皮瓣转移乳房重建术后,保留乳头乳晕与不保留乳头乳晕的临床疗效以及美容效果的差异。方法采用回顾性研究分析保留乳头乳晕乳房重建33例和不保留乳头乳晕乳房重建24例患者的临床资料,所有患者均收治于梅州市人民医院乳腺外科,时间为2017年1月—2018年12月。患者组间生存曲线、临床病理特征和生存差异分析分别采用卡方检验、乘积极限法以及Log-rank检验;比较两组患者术后乳房重建效果以及术后并发症有无统计学差异。结果保留乳头晕组与不保留乳头晕组乳腺癌患者的临床病理特征差异无统计学意义(P>0.05)。57例乳腺癌患者的3年无病生存率为91.23%,3年总生存率100.00%。其中保留乳头乳晕乳房重建组的3年无病生存率为93.94%,不保留乳头乳晕乳房重建组为87.50%,组间差异无统计学意义(P>0.05)。对保留乳头乳晕乳房重建组与不保留乳头乳晕乳房重建组的术后美容效果以及患者自身满意度分析,组间存在差异有统计学意义(P<0.05),保留乳头乳晕乳房重建组术后美容效果及患者自身满意度均优于不保留乳头乳晕乳房重建组。保留乳头乳晕乳房重建组并发症的总发生率为36.36%,不保留乳头乳晕乳房重建组并发症的总发生率为41.67%,两组患者之间的并发症比较,差异无统计学意义(P>0.05)。结论保留乳头乳晕乳腺癌全切即刻背阔肌带蒂肌皮瓣转移乳房重建术在预后及术后并发症上与不保留乳头乳晕乳腺癌全切即刻背阔肌带蒂肌皮瓣转移乳房重建术相似,但保留乳头乳晕乳房重建术具有更美观、患者满意度更高的优势。Objective To explore the clinical efficacy and the difference of cosmetic effect between nipple-areola-preserving and nipple-areola-removal after breast reconstruction with immediate latissimus dorsi pedicled musculocutaneous flap translocation and total mammary gland resection in patients with breast cancer.Methods The clinical data of 33 patients with nipple-areola-preserving in breast reconstruction and the clinical data of another 24 patients with nipple-areola-removal in breast reconstruction were retrospectively analyzed.All of the patients were admitted to the Department of Breast Surgery,Meizhou People’s Hospital from January 2017 to December 2018.The Chi-square test,Kaplan-Meier method and Log-rank test were used to analyze the survival curves,clinicopathological features and survival difference analysis respectively between the two groups.Then statistical differences between the two groups were determined by comparing the postoperative breast reconstruction effect and postoperative complications.Results There was no significant statistical difference in clinicopathological features between the nipple-areola-preserving group and the nipple-areola-removal group(P>0.05).The 3-year disease-free-survival(DFS)of 57 patients was 91.23%,and the 3-year overall-survival(OS)was 100%.Specifically,the 3-year DFS of the nipple-areola-preserving group and the nipple-areola-removal group were 93.94% and 87.50%,respectively,and in this respect,there was no statistically significant difference between the two groups(P>0.05).There were significant statistical differences in the aspects of postoperative cosmetic results and patient satisfaction between the two groups(P<0.05):the two aspects of the nipple-areola-preserving group were better than those of the nipple-areola-removal group with.The total incidence of complications in the nipple-areola-preserving group was 36.36%,while that in the nipple-areola-removal group was 41.67%,with no significant statistical difference between the two groups(P>0.05).Conclusion In term

关 键 词：乳腺癌 保留乳头乳晕 即刻背阔肌带蒂肌皮瓣 乳房重建 临床疗效 

分 类 号：R739.9[医药卫生—肿瘤]