腔镜乳腺癌保乳根治术后一期带蒂大网膜乳房重建术的临床效果探讨  

An exploration on the clinical effect of one-stage breast reconstruction with pedicled omental flap after endoscopic radical breast-conserving surgery for breast cancer

作　　者：赖嘉欣 林小甜 何琳赟 朱燕雯 廖玥 朱迪 罗云峰[1] 张普生[1] LAI Jia-xin;LIN Xiao-tian;HE Lin-yun(Department of Breast Surgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学珠江医院乳腺外科,广州510280

出　　处：《中国临床新医学》2023年第9期880-884,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广州市临床特色技术项目(编号:2023P-TS23);南方医科大学珠江医院医疗新技术项目(编号:202101001,XJS202301001)。

摘　　要：目的探讨腔镜乳腺癌保乳根治术后一期带蒂大网膜乳房重建术的临床效果及术后并发症发生的预防。方法回顾性分析2017年5月至2023年3月南方医科大学珠江医院收治的32例早期乳腺癌患者的临床资料,均在腹腔镜下获取带蒂大网膜行乳房重建术。总结分析其基线资料、手术结果、术后并发症、复发及转移情况等。结果所有患者在腔镜辅助下成功获取大网膜,无中途转为开放手术的病例。术后随访时间为4~71个月,平均21.34个月。术后发生腹壁切口疝1例(3.13%),切口感染2例(6.25%),总并发症发生率为9.38%(3/32)。切口感染患者在采取抗感染、规律换药后均得到改善。对腹壁切口疝患者行切口疝修补术,后续无复发。结论腔镜辅助下获取带蒂大网膜行乳房重建术能获得良好重建效果,但亦可发生相应的并发症,改善术中操作步骤,术后及时采取特定的措施可减少并发症的发生,获得良好的手术效果。Objective To explore the clinical effect and prevention of postoperative complications of one-stage breast reconstruction with pedicled omental flap after endoscopic radical breast-conserving surgery for breast cancer.Methods The clinical data of 32 patients with early breast cancer who were admitted to Zhujiang Hospital,Southern Medical University from May 2017 to March 2023 were retrospectively analyzed.All the patients underwent one-stage breast reconstruction with pedicled omental flap after endoscopic radical breast-conserving surgery for breast cancer.The baseline data,surgical results,postoperative complications,recurrence and metastasis of the patients were summarized.Results The pedicled omental flaps were successfully obtained with the assistance of laparoscopy in all the patients,and no cases were converted to open surgery midway.The postoperative follow-up period was 4-71 months,and the mean follow-up period was 21.34 months.Postoperative incisional hernia of the abdominal wall occurred in 1 case(3.13%)and incisional infections in 2 cases(6.25%).The total complication rate was 9.38%(3/32).The patients with incisional infections were improved after anti-infections and regular dressing changes.The patient with postoperative incisional hernia of the abdominal wall had no relapse after incisional hernia repair surgery.Conclusion Breast reconstruction surgery can achieve ideal reconstruction results after obtaining the pedicled omental flaps under the assistance of laparoscopy,but the corresponding complications can also occur.Improving the operation procedure during the surgery and taking specific measures in time after surgery can reduce the occurrence of complications and obtain good surgical results.

关 键 词：乳腺癌 腔镜技术 带蒂大网膜 乳房重建 并发症 

分 类 号：R737.9[医药卫生—肿瘤]