摘要
目的探讨保留皮肤的乳腺癌改良根治术后即刻乳房假体再造的临床应用价值。方法我院2006年1月至2009年12月期间收治的28例乳腺癌患者行保留皮肤的乳腺癌改良根治术后,同时于胸大肌后置入硅胶假体再造乳房,对围手术期结果、乳房外观评价以及随访结果进行分析。结果本组28例患者均行腋窝淋巴结清扫术,清除淋巴结数目为14~32枚,中位数为21枚。手术时间为117~140 min（平均126 min）,术中出血量为82~124 ml（平均98 ml）,术后引流管拔除时间为3~5 d。所有患者术后均无伤口积液、感染、皮肤坏死、异物反应等,22例保留了乳头乳晕复合体的患者均无乳头乳晕缺血、坏死。患者术后乳房外观评价中,10例为优,18例为良,优良率为100%。所有患者术后均获随访,随访时间为12~48个月（中位随访时间24个月）,未发现有远处转移和局部复发,无上肢水肿及功能障碍。所有患者乳房外观及手感满意,无纤维包膜挛缩。结论保留皮肤的乳腺癌改良根治术后用硅胶假体行即刻乳房再造具有创伤小、安全、手术操作简单、术后恢复快的特点,再造后乳房美观,效果满意,值得临床推广。
Objective To investigate the clinical application value of immediate breast reconstruction using silicon implant after skin-sparing modified radical mastectomy for patients with breast cancer.Methods A total of 28 patients with breast cancer undergoing immediate breast reconstruction using silicon implant after skin-sparing modified radical mastectomy from January 2006 to December 2009 were included in this study.The perioperative results,breast appearance evaluation and follow-up results were analyzed.Results All 28 patients received axillary lymph node dissection and the number of lymph node dissected was 14-32（median 21）.The operation time was 117-140 min（mean 126 min）,blood loss was 82-124 ml（mean 98 ml）,and the time to drainage tube removal was 3-5 d.No wound infection,skin necrosis,and foreign body reaction occurred in all the patients,especially in 22 patients underwent nipple-areola complex-sparing mastectomy,no ischemia or necrosis occurred in nipple-areola complex.For evaluation of breast appearance,excellent was in ten cases and good in 18 cases,thus,the excellent and good rate was 100%.All patients were followed up for 12-48 months（median 24 months） after operation,and distant metastasis,local recurrence,upper extremity edema,and dysfunction were not found.No fiber kystis contracture was found and all patients were satisfied with breast appearance and good handfeels.Conclusions Immediate breast reconstruction using silicon implant after skin-sparing modified radical mastectomy has the advantage of minimal invasion,safety,simple operation,and quick postoperative recovery for patients with breast cancer and the appearance of reconstructed breast is excellent,which can be clinically used widely.
出处
《中国普外基础与临床杂志》
CAS
2011年第9期956-960,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
乳腺癌
改良根治术
乳房再造
硅胶假体
乳头乳晕复合体
Breast cancer
Radical mastectomy
Breast reconstruction
Silicon implant
Nipple-areola complex
