单孔腔镜下乳房切除术同期行全胸肌后假体植入乳房重建疗效观察  

Efficacy of single-port endoscopic mastectomy plus immediate total pectoral muscle reconstruction with breast implants

作　　者：王甲彬 阮玉霞 杨晗昭 乔江华 WANG Jiabin;RUAN Yuxia;YANG Hanzhao;QIAO Jianghua(Department of Breast Surgery,Cancer Hospital Affiliated to Zhengzhou University,Henan Cancer Hospital,Zhengzhou,Henan 450008,China)

机构地区：[1]郑州大学附属肿瘤医院河南省肿瘤医院乳腺科,河南郑州450008

出　　处：《中华实用诊断与治疗杂志》2024年第9期880-883,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省自然科学基金(232300420040)。

摘　　要：目的观察中小乳房(乳房容量<300 mL)乳腺癌患者单孔腔镜下保留乳头乳房切除术(NSM)同期行全胸肌后假体植入乳房重建术治疗的效果,探讨其安全性。方法回顾性分析2021年8月—2023年8月郑州大学附属肿瘤医院经腋窝入路单孔腔镜下NSM同期行全胸肌后假体植入乳房重建术的22例中小乳房乳腺癌患者的临床资料,记录手术时间、术中出血量、手术情况、术后引流量、术后住院时间以及术后切口感染、切口裂开、皮瓣缺血坏死、运动畸形、胸壁疼痛、皮下气肿血肿形成等并发症发生情况。行腋窝淋巴结清扫者术后行乳房、腋窝区域放疗。术后每3个月门诊随访1次,记录肿瘤复发、远处转移及死亡情况,对乳房重建效果的满意度,行放疗者假体取出或包膜挛缩发生情况。结果22例手术均顺利,无中转开放手术病例,手术时间(220.0±12.8)min,术中出血量(35.0±4.5)mL,术后引流量(480±36)mL,术后住院时间14(10,20)d。10例行腋窝淋巴结清扫术者术后行乳房及腋窝区域放疗。中位随访24个月,22例均存活,肿瘤均未复发、转移,患者对乳房重建效果满意,均未发生假体取出或包膜挛缩。结论中小乳房乳腺癌患者经腋窝入路单孔腔镜下NSM同期行全胸肌后假体植入乳房重建术安全、有效,乳房重建效果好,术后并发症少。Objective To observe the efficacy of single-port endoscopic nipple-sparing mastectomy(NSM)plus immediate total pectoral muscle reconstruction with breast implants in patients with breast cancer(breast volume<300 mL),and to explore its safety.Methods Twenty-two small and medium-volume breast patients with breast cancer underwent transaxillary single-port endoscopic NSM and immediate total pectoral muscle reconstruction with breast implants in Cancer Hospital Affiliated to Zhengzhou University from August 2021 to August 2023,and their clinical data were retrospectively analyzed.The surgical time,intrasurgical blood loss,surgical procedures,postsurgical drainage volume,length of postsurgical hospital stay,and postsurgical complications as incision infection,incision dehiscence,flap ischemic necrosis,movement deformity,chest wall pain,and subcutaneous emphysema hematoma were recorded.Those with axillary lymph node dissection underwent postsurgical radiotherapy to the breast and armpit.Patients were followed up postsurgically in the outpatient clinic every 3 months,and the recurrence,distant metastasis,death,patients'satisfaction with the breast reconstruction,and prosthesis removal and capsular contracture in those receiving radiotherapy were recorded.Results All surgeries were successfully completed,with no intrasurgical conversion to open surgery.The surgery lasted for(220.0±12.8)min,the intrasurgical blood loss was(35.0±4.5)mL,the postsurgical drainage volume was(480±36)mL,and the postsurgical hospital stay was 14(10,20)d.Ten patients were subjected to axillary lymph node dissection and subsequent regional radiotherapy.The median follow-up was 24 months,revealing a survival in all patients.No recurrence or metastasis occurred.The patients were satisfied with the breast reconstruction outcome.No prosthesis removal or capsular contracture was found.Conclusions Transaxillary single-port endoscopic NSM plus immediate total pectoral muscle reconstruction with breast implants is safe and effective for small and mediu

关 键 词：乳腺癌 中小乳房 单孔腔镜 保留乳头乳房切除术 全胸肌后假体植入乳房重建术 

分 类 号：R737.9[医药卫生—肿瘤]