不同部位皮瓣移植对乳腺癌保乳术患者肿瘤学安全性及乳房缺损修复效果的影响  

Effects of skin flap transplantation in different parts on the oncology safety and breast defect repair in breast cancer patients undergoing breast-conserving surgery

作　　者：张辉 张颖 华江伟 张松 ZHANG Hui;ZHANG Ying;HUA Jiangwei;ZHANG Song(Department of Thyroid and Breast Surgery,the Third People's Hospital of Yunnan Province,Kunming 650101,Yunnan,China)

机构地区：[1]云南省第三人民医院甲状腺乳腺外科,昆明650101

出　　处：《中国性科学》2022年第7期95-98,共4页Chinese Journal of Human Sexuality

基　　金：云南省教育厅科学研究基金项目(2022J0709)。

摘　　要：目的观察不同部位皮瓣移植对乳腺癌保乳术患者肿瘤学安全性及乳房缺损修复效果的影响。方法选取2018年6月至2020年6月云南省第三人民医院收治的76例乳腺癌保乳术患者作为研究对象,根据乳房修复方式的不同分为胸外侧组(n=39)、背阔肌组(n=37)。胸外侧组行胸外侧筋膜皮瓣移植,背阔肌组行背阔肌肌皮瓣移植。比较两组手术情况、术后并发症、术前及术后1年乳房外观指标(乳头至胸骨上窝距离、乳头至中线距离)和术后1年乳房优良率、乳腺癌复发率及远处转移率。结果胸外侧组手术时间较背阔肌组短,术中出血量较背阔肌组少(P<0.05);胸外侧组术后并发症发生率(5.13%)低于背阔肌组(24.32%)(P<0.05);两组术后1年乳头至胸骨上窝距离、乳头至中线距离比较,差异无统计学意义(P>0.05);两组术后1年乳房优良率、乳腺癌复发率及远处转移率比较,差异无统计学意义(P>0.05)。结论胸外侧筋膜皮瓣移植与背阔肌肌皮瓣移植应用于乳腺癌保乳术患者的乳房缺损修复效果及肿瘤学安全性均较好,但前者具有手术时间短、创伤轻、并发症少等优势,临床价值更高。Objective To observe the effect of skin flap transplantation in different parts on the oncology safety and breast defect repair of breast cancer patients undergoing breast-conserving surgery.Methods A total of 76 breast cancer patients undergoing breast-conserving surgery in the Third People's Hospital of Y unnan Province from June 2018 to June 2020 were selected and divided into lateral thoracic group(n=39)and latissimus dorsi group(n=37)according to different breast repair methods.The lateral thoracic group received lateral thoracic fasciocutaneous flap transplantation,and the latissimus dorsi group received latissimus dorsi myocutaneous flap transplantation.Surgical conditions,complications,breast appearance index(distance from nipple to superior sternal fossa,distance from nipple to midline)before operation and 1 year after operation,breast excellent and good rate,breast cancer recurrence rate,and distant metastasis rate 1 year after operation were compared between the two groups.Results The operation time of the lateral thoracic group was shorter than that of the latissimus dorsi group,and the intraoperative blood loss was less than that of the latissimus dorsi group(P<0.05);the postoperative complication rate of the lateral thoracic group(5.13%)was lower than that of the latissimus dorsi group(24.32%)(P<0.05);there was no statistically significant difference in the distance from the nipple to the superior sternal fossa and the distance from the nipple to the midline at 1 year after surgery(P>0.05);there was no statistically significant difference in the breast excellent and good rate,recurrence rate and distant metastasis rate between the two groups at 1 year after operation(P>0.05).Conclusions Lateral thoracic fasciocutaneous flap transplantation and latissimus dorsi musculocutaneous flap transplantation have good results in breast defect repair and oncology safety in breast cancer patients undergoing breast-conserving surgery,but the former has short operation time,mild trauma,fewer complications,which ha

关 键 词：胸外侧筋膜皮瓣移植 背阔肌肌皮瓣移植 乳腺癌 保乳术 肿瘤学 乳房缺损 

分 类 号：R711[医药卫生—妇产科学]