肿瘤整形切口联合容量移位在早期乳腺癌保乳治疗中的应用  

Application value of the neoplastic incision combined with volume displacement in conserving breast treatment of early breast cancer

作　　者：刘先富 张晓静 陈延松 张浩 乔梦祥 LIU Xianfu;ZHANG Xiaojing;CHEN Yansong;ZHANG Hao;QIAO Mengxiang(Department of Oncology,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院肿瘤外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2024年第5期580-584,共5页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(2023AH051944)。

摘　　要：目的:探讨肿瘤整形切口联合容量移位在早期乳腺癌保乳手术中的治疗及美容效果。方法:选取符合保乳条件且有保乳意愿病人96例,根据病人意愿分为整形保乳组和常规保乳组,各48例。整形保乳组根据肿瘤位置及大小,个体化、灵活选择肿瘤整形保乳常用的双环法、网球拍、蝙蝠翼、平行四边形等切口,在切除肿瘤的同时,通过容量移位技术填充肿瘤切除部位的缺损,达到美容保乳目的;常规保乳组行肿瘤及周围腺体组织扩大切除后,仅行腺体部分缝合。比较2组病人手术时间、术中出血量、术后住院时间和感染、皮下积液发生情况及引流量等围手术期指标,并采用Harris美容评分及问卷调查评估2组术后6个月的美容效果、乳房满意度、复发转移及再手术情况。结果:整形保乳组较常规保乳组手术时间延长、术中出血量增多(P<0.01),术后3 d总引流量减少(P<0.01),2组住院时间差异无统计学意义(P>0.05)。2组术后皮下积液、切口感染、皮瓣坏死及切口裂开差异均无统计学意义(P>0.05)。术后随访6个月,整形保乳组美容效果及病人满意度均明显高于常规保乳组(P<0.01),2组肿瘤局部复发、转移及再次手术率差异均无统计学意义(P>0.05)。结论:肿瘤整形切口联合容量移位将肿瘤切除与整形技术相结合,兼顾美学效果,不增加手术并发症及肿瘤复发转移风险,为病人提供了更为人性化的治疗选择,提升了病人术后生活质量。Objective:To explore the cosmetic effects of the neoplastic incision combined with volume displacement in conserving breast treatment of early breast cancer.Methods:A total of 96 patients,who met the conditions of breast-conserving and had the intention of breast-conserving,were selected,and divided into the plastic breast-conserving group and the conventional breast-conserving group according to their wishes(48 cases each group).According to the location and size of the tumor,the common incisions such as double-ring method,tennis racket,batwing,parallelogram,etc.,were individually and flexibly selected in the plastic breast-conserving group.At the same time of tumor resection,the defect of the tumor resection site was filled by volume displacement technology to achieve the purpose of cosmetic breast preservation.Only partial glandular in the conventional breast-conserving group was sutured after the tumor and surrounding glandular tissue resection.The perioperative indexes such as the operation time,intraoperative blood loss,postoperative hospital stay,infection,occurrence of subcutaneous effusion and drainage volume were compared between two groups.The Harris aesthetic score and questionnaire survey were used to evaluate the aesthetic effects,postoperative breast satisfaction,recurrence and metastasis and reoperation of two groups after 6 months of surgery.Results:Compared with the conventional breast-conserving group,the operation time was longer,the intraoperative blood loss was more(P<0.01),and the total drainage volume after 3 days of surgery decreased in the plastic breast-conserving group(P<0.01).There was no statistical significance in the hospital stay between two groups(P>0.05).There was no statistical significance in the subcutaneous effusion,incision infection,flap necrosis and disruption of incision between two groups(P>0.05).After 6 months of follow-up,the cosmetic effects and patient satisfaction in the plastic breast-conserving group were significantly higher than those in conventional breast-con

关 键 词：乳腺肿瘤 整形保乳术 常规保乳术 

分 类 号：R737.9[医药卫生—肿瘤]