单孔充气法腔镜胸肌前假体置入乳房重建术对比开放胸肌后假体置入乳房重建术的回顾性队列研究  

Single-port insufflation technique-assisted endoscopic nipple-sparing mastectomy with immediate prepectoral prosthesis breast reconstruction versus conventional nipple-sparing mastectomy with immediate subpectoral prosthesis breast reconstruction:a retrospective cohort study

作　　者：吕靖芳 王子函[1] 王朝斌[1] 彭媛[1] 杨阳[1] 杜炜 王思源[1] 杨柳[1] 刘淼[1] Lyu Jingfang;Wang Zihan;Wang Chaobin;Peng Yuan;Yang Yang;Du Wei;Wang Siyuan;Yang Liu;Liu Miao(Department of Breast Surgery,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院乳腺外科,北京100044

出　　处：《中华普通外科杂志》2024年第7期521-526,共6页Chinese Journal of General Surgery

摘　　要：目的对比腔镜胸肌前假体置入乳房重建术和传统开放胸肌后假体置入乳房重建术在手术安全性和术后美容效果两方面的差异。方法通过回顾性队列研究分析北京大学人民医院外科于2022年10月1日至2023年9月13日收治的早期乳腺癌患者的临床资料。结果按照手术方式分为腔镜手术组(30例)和传统手术组(46例)。腔镜手术组和传统手术组患者在基础临床病理资料、前哨淋巴结检出数目和腋窝淋巴结清扫数目方面差异均无统计学意义(均P>0.05)。相比较传统手术组,腔镜手术组患者的手术时间延长,术后第3天伤口引流量较多(均P<0.05)。两组患者发生术后并发症的概率差异均无统计学意义(均P>0.05),但腔镜手术组患者出现乳头乳晕复合体坏死的比例(10.0%)较传统手术组(26.1%)低。结论单孔充气法腔镜胸肌前假体置入乳房重建术实现了美容效果的最大化。在严格选择适应证的前提下,其可以成为一种可选择的手术方式。ObjectiveTo compare the differences in surgical safety and postoperative cosmetic effects between endoscopic nipple-sparing mastectomy with immediate prepectoral prosthesis breast reconstruction and conventional nipple-sparing mastectomy with immediate subpectoral prosthesis breast reconstruction.MethodsThe clinical data of early breast cancer patients admitted to the Department of Breast Surgery of Peking University Peoples Hospital from Oct 1,2022 to Sep 13,2023 was retrospectively analyzed.ResultsAccording to the surgical method,the patients were divided into endoscopic surgery group(30 cases)and traditional surgery group(46 cases).There were no significant differences in the basic clinicopathological data,and the number of sentinel lymph nodes taken and axillary lymph nodes dissected between the patients in two groups(all P>0.05).Compared with that in traditional surgery group,the patients in endoscopic surgery group had longer operation time and more wound drainage volumes 3 days after surgery(all P<0.05).There was no significant differences in the probability of postoperative complications between the patients in two groups(all P>0.05),however,the proportion of nipple-areola complex necrosis in patients of endoscopic surgery group(10.0%)was lower than that of traditional surgery group(26.1%).ConclusionsThe single-port insufflation technique-assisted endoscopic nipple-sparing mastectomy with immediate prepectoral prosthesis breast reconstruction maximize the cosmetic effect.Under the premise of strict selection of indications,it can be an optional surgical method.

关 键 词：乳腺肿瘤 外科手术 腔镜 假体置入 

分 类 号：R737.9[医药卫生—肿瘤]