3D成像技术联合胸外侧动脉穿支皮瓣用于乳腺癌保乳整形手术研究  

Application of 3D imaging technology combined with lateral thoracic artery perforator flap in breast-conserving plastic surgery for breast cancer

作　　者：徐元兵 潘代 刘懿 康嗣如 沈浩元[1] 孙鑫 苏婷婷 胡超华[1] XU Yuan-bing;PAN Dai;LIU Yi(不详;Department of Thyroid and Breast Surgery,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432100,China)

机构地区：[1]武汉科技大学附属孝感医院甲状腺乳腺外科,湖北孝感432100 [2]武汉科技大学附属孝感医院超声科,湖北孝感432100 [3]武汉科技大学附属孝感医院妇瘤科,湖北孝感432100 [4]武汉科技大学附属孝感医院磁共振室,湖北孝感432100

出　　处：《中国实用外科杂志》2023年第4期444-448,共5页Chinese Journal of Practical Surgery

基　　金：湖北省科技厅大健康领域重点项目(No.2022BCE041);湖北省卫生健康委员会面上项目(No.WJ2019M079);孝感市自然科学基金(No.XGKJ2022010006)。

摘　　要：目的探讨3D成像技术联合胸外侧动脉穿支(LTAP)皮瓣在乳腺癌保乳整形手术中的临床应用价值。方法回顾性分析2020年3月至2022年9月武汉科技大学附属孝感医院甲状腺乳腺外科收治的应用3D成像技术联合LTAP皮瓣修复乳房部分缺损的32例乳腺癌病人的临床资料。所有病人术前均进行乳腺3D重建,计算术前患侧乳房体积(UBV)和术前预计切除组织体积(PETV)。保乳整形术后进行组织标本切缘病理学评价及乳房美学评价。结果所有32例病人均成功完成手术,且术后无明显肿瘤复发。32例病人PETV为(55.1±15.2)m L,PETV/UBV范围为0.20~0.47,AETV为(59.7±17.3)m L,PETV与术中实际切除组织体积(AETV)的差异无统计学意义(P>0.05),两者具有较好的一致性(P<0.01)。所有病人保乳术后切缘均为阴性,术后未发生出血和感染。术后6个月,BREAST-Q量表评分乳房满意度为(82.2±2.4)分,胸壁状态评分为(92.8±2.8)分,社会心理状态评分为(90.5±3.8)分,性健康程度评分为(75.6±7.4)分。结论在乳腺癌保乳整形手术中利用3D成像技术能较好预测切除组织体积,联合使用LTAP皮瓣填充保乳术后残腔缺损能有效提高手术美容效果。Objective To investigate the clinical application value of 3D imaging technology combined with lateral thoracic artery perforator flap in breast-conserving plastic surgery for breast cancer.Methods The clinical data of 32 patients with breast cancer treated with 3D imaging combined with LTAP flap for partial breast defect repair in a single center from March 2020 to September 2022 were retrospectively analyzed.All patients underwent 3D breast reconstruction before surgery,and PETV was calculated before surgery.Histological and aesthetic evaluation of breast were performed after breast conserving plastic surgery.Results All 32 patients successfully completed the operation,and there was no obvious tumor recurrence after operation.The average PETV of 32 patients was(55.1±15.2)mL,the PETV/UBV range was 0.20-0.47,and the AETV was(59.7±17.3)mL.There was no significant difference between PETV and AETV(P>0.05),both had a good consistency(P<0.01).Resection margin was negative in all patients after breast-conserving surgery,and no postoperative bleeding or infection.The BREAST-Q scores 6 months after operation showed the postoperative breast satisfactory degree,chest wall status score,psychosocial status score,and sexual health score were 82.2±2.4,92.8±2.8,90.5±3.8,75.6±7.4.Conclusion 3D imaging technology can better predict the volume of resected tissue in breast conserving plastic surgery,and the combination of LTAP flap to fill the residual cavity defect after breast conserving surgery can effectively improve the aesthetic outcome of surgery.

关 键 词：乳腺癌 保乳 3D成像 胸外侧动脉 皮瓣 

分 类 号：R6[医药卫生—外科学]