游离大网膜在乳腺癌术后即刻乳房重建术中的应用  

Application of dissociated omentum in immediate breast reconstruction after breast cancer surgery

作　　者：阚炳华 邵远 燕归如 申武峰 徐子森 薛辉[2] KAN Bing-hua;SHAO Yuan;YAN Gui-ru(Department of Oncological Surgery,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院肿瘤外科,陕西汉中723000 [2]汉中市中心医院肿瘤内科

出　　处：《腹腔镜外科杂志》2023年第5期321-325,共5页Journal of Laparoscopic Surgery

基　　金：陕西省卫健委科研基金(2021D017)。

摘　　要：目的:比较腔镜下游离大网膜为乳腺癌患者即刻乳房重建与单纯假体一期乳房重建的治疗效果。方法:回顾分析2019年6月至2021年6月经病理诊断为乳腺癌且进行乳房重建手术的78例患者的临床资料,根据手术方式分为观察组(n=36)与对照组(n=42),观察组行腔镜下游离大网膜即刻乳房重建术,对照组行单纯假体一期乳房重建术。观察两组患者恢复情况、术后生活质量、局部复发率、远处转移率、病死率、美学评分等相关指标,评价两种手术的疗效。结果:观察组手术时间、术中出血量多于对照组,差异有统计学意义(P<0.05);住院时间短于对照组,差异有统计学意义(P<0.05)。两组在术后并发症(3 vs.4)、美学评分优良率(97.2%vs.95.2%)及患者满意度(86.1%vs.88.1%)方面差异无统计学意义。术后随访6~30个月,两组均无死亡病例,观察组与对照组局部复发率(0 vs.2.4%)与远处转移率(8.3%vs.11.9%)差异无统计学意义(P>0.05)。结论:腔镜下游离游离大网膜乳腺癌术后即刻乳房重建术与单纯假体一期乳房重建术的治疗效果相当,具有安全、美观等优点,值得临床应用与推广。Objective:To compare the therapeutic effect of dissociated omentum under laparoscopy for immediate breast reconstruction and one-stage breast reconstruction with prosthesis for breast cancer patients.Methods:The clinical data of 78 patients,who were pathologically diagnosed with breast cancer and underwent breast reconstruction surgery from Jun.2019 to Jun.2021,were retrospectively analyzed.Patients were divided into observation group(n=36)and control group(n=42)according to the surgical method.The observation group underwent endoscopic separation of omentum and immediate breast reconstruction.The control group underwent single prosthesis one-stage breast reconstruction.The recovery,postoperative quality of life,local recurrence rate,distant metastasis rate,fatality rate,and aesthetic score of the two groups were compared and analyzed,and the curative effects of the two operations were evaluated.Results:The operation time and intraoperative blood loss of the observation group were significantly more than those of the control group,and the difference was statistically significant(P<0.05),but the hospitalization time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).Postoperative complications(3 vs.4),aesthetic scores distinguished achiever ratio(97.2%vs.95.2%)and the patient satisfaction degree(86.1%vs.88.1%)were not statistically significantly different between the 2 groups.During the follow-up of 6 to 30 months,no cases of death were observed in both groups.There was no significant difference in the local recurrence rate(0 vs.2.4%)and the distant metastasis rate(8.3%vs.11.9%,P>0.05).Conclusions:Immediate breast reconstruction after breast cancer surgery using endoscopic separation of greater omentum has the same therapeutic effect as one-stage breast reconstruction with simple prosthesis.It has the advantages of safety and aesthetics,and is worthy of clinical application and promotion.

关 键 词：乳腺肿瘤 乳房成形术 网膜 内窥镜检查 

分 类 号：R737.9[医药卫生—肿瘤]