容量移位整形术修复乳腺癌保乳术后乳房缺损的临床疗效观察  

Clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery

作　　者：许波 郑荆洲 张泽 XU Bo;ZHENG Jingzhou;ZHANG Ze(Department of Thyroid and Breast Surgery,Minda Hospital of Hubei Minzu University,Enshi,Hubei 445000,P.R.China)

机构地区：[1]湖北民族大学附属民大医院甲状腺乳腺外科,湖北恩施445000

出　　处：《中国普外基础与临床杂志》2024年第1期74-79,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探究容量移位整形术修复乳腺癌保乳术后乳房缺损的临床疗效。方法根据纳入和排除标准回顾性收集2013年2月至2020年3月期间湖北民族大学附属民大医院收治的乳腺癌保乳术后乳房缺损患者,根据乳房整形方式分为容量移位整形术组(简称“容量移位组”)和容积替代整形术组(简称“容积替代组”),比较2组患者的近期疗效(包括切口长度、手术时间、术中出血量、切除标本体积、乳房美容效果、患者主观满意度、术后并发症及总住院时间)和远期疗效(包括局部复发、3年无瘤生存率和3年总生存率)情况。结果本研究共纳入符合研究条件的患者208例,其中容量移位组105例,容积替代组103例;倾向评分匹配后62例,其中容量移位组33例,容积替代组29例。2组患者除容量移位组的病灶最大径小于容积替代组(P<0.05)外,2组的其他基线资料比较差异无统计学意义(P>0.05)。2组患者的切口长度、手术时间、总住院时间、术后总并发症发病率以及局部复发率、3年无瘤生存率和3年总生存率比较差异均无统计学意义(P>0.05),而与容积替代组比较,容量移位组的术中出血量更少(t=3.294,P=0.002)、切除标本体积更小(t=2.030,P=0.047),美容效果和患者主观满意度更好(Z=2.297,P=0.022;Z=2.256,P=0.024)。结论从本研究中相对有限的病例数据分析结果提示,容量移位整形术修复乳腺癌保乳术后乳房缺损可获得更佳的美容效果及较高的患者主观满意度,并且不增加术后并发症和肿瘤复发的风险,远期效果也较好。Objective To explore the clinical efficacy of volume displacement techniques for breast defects following breast conserving surgery.Methods After inclusion and exclusion,the patients with breast defects following breast conserving surgery in the Minda Hospital of Hubei Minzu University from February 2013 to March 2020 were retrospectively enrolled,and were assigned into a volume displacement group and volume replacement group according to different surgical techniques.Then the outcomes were compared between the two groups,including short-term efficacy(incision length,operation time,intraoperative blood loss,volume of resected specimen,cosmetic effect,patients’subjective satisfaction,total postoperative complications,and total hospitalization time)and long-term efficacy(local recurrence rate,3-year tumor-free survival,and 3-year overall survival).Results A total of 208 eligible patients were included in this study,including 105 in the volume displacement group and 103 in the volume replacement group before propensity score matching(PSM);after PMS,a total of 62 patients were enrolled,including 33 in the volume displacement group and 29 in the volume replacement group.No statistical difference was reported in the baseline data between two groups(P>0.05),except that the maximum diameter of lesion in the volume displacement group was smaller than that in the volume replacement group(P<0.05).The incision length,operation time,total hospitalization time,total postoperative complication rate,local recurrence rate,3-year tumor-free survival rate,and 3-year overall survival rate had no statistical differences between the two groups(P>0.05),whereas the intraoperative blood loss was less(t=3.294,P=0.002)and the volume of resected specimen was smaller(t=2.030,P=0.047)in the volume displacement group as compared with the volume replacement group,and the cosmetic effect and patients’subjective satisfaction were better in the volume displacement group as compared with the volume replacement group(Z=2.297,P=0.022;Z=2.256,P=0.

关 键 词：容量移位技术 整形保乳术 乳腺癌 乳房缺损 预后 

分 类 号：R737.9[医药卫生—肿瘤]