摘要
目的研讨腔镜辅助下保留乳头乳晕全乳切除(NSM)并假体植入重建乳房的美学效果与安全性。方法回顾性整理2024年1月至2025年4月于厦门大学附属第一医院行乳房重建的60例乳腺癌患者资料,并按照手术方案分为对照组(30例,行开放NSM术并假体植入)和观察组(30例,行腔镜辅助下NSM术并假体植入),比较两组手术基础指标、并发症、美学效果及患者主观评价。结果两组手术时间、假体容量对比,差异无统计学意义(P>0.05),观察组其余各项手术基础指标(术中失血量、术后2 d引流量及平均住院日)减少相比对照组均更显著,差异有统计学意义(P<0.05)。观察组出现并发症的患者占比与对照组相近,差异无统计学意义(P>0.05)。观察组乳房外观、两侧乳房对称性、乳头乳晕复合体、皮肤、瘢痕得分及总分相比对照组均更高,差异有统计学意义(P<0.05)。观察组患者主观评价(总满意度96.67%)相比对照组(73.33%)更高,差异有统计学意义(P<0.05)。结论相比开放NSM术并假体植入,若克服学习曲线,腔镜辅助下NSM术并假体植入用于乳腺癌患者的乳房重建用时接近、术中失血更少、术后恢复更快,并可在保障手术安全性的同时,提升乳房美学效果及患者主观评价。
Objective To investigate the aesthetic effect and safety of endoscopic assisted nipple sparing areola total mastectomy(NSM)and breast reconstruction with prosthesis implantation.Methods Retrospective analysis of 60 breast cancer patients who underwent breast reconstruction at the First Affiliated Hospital of Xiamen University from January 2024 to April 2025 was conducted.The patients were divided into a control group(30 cases,undergoing open nipple-sparing mastectomy with implant placement)and an observation group(30 cases,undergoing endoscopic-assisted nipple-sparing mastectomy with implant placement).The surgical baseline indicators,complications,aesthetic outcomes,and patient subjective evaluations were compared between the two groups.Results There was no statistically significant difference in surgical duration and prosthesis volume between the two groups(P>0.05).The observation group showed significantly lower levels in other surgical baseline indicators(intraoperative blood loss,postoperative 2-day drainage volume,and average hospital stay)compared to the control group,with statistically significant differences(P<0.05).The proportion of patients with complications in the observation group was similar to that in the control group,with no statistically significant difference(P>0.05).The observation group scored higher in breast appearance,bilateral breast symmetry,nipple-areola complex,skin,scar,and total scores compared to the control group,with statistically significant differences(P<0.05).The subjective evaluation(overall satisfaction rate of 96.67%)in the observation group was significantly higher than that in the control group(73.33%),with a statistically significant difference(P<0.05).Conclusions Compared with open NSM surgery and prosthesis implantation,if the learning curve is overcome,endoscopic assisted NSM surgery and prosthesis implantation can be used for breast reconstruction of breast cancer patients with similar time,less intraoperative blood loss,faster postoperative recovery,and can improve the breast aesthetic effect and patient subjective evaluation while ensuring the safety of surgery.
作者
梁婧
何巧宁
高碧丽
LIANG Jing;HE Qiaoning;GAO Bili(Department of breast surgery,the First Affiliated Hospital of Xiamen University,Xiamen 361000,Fujian Province,China)
出处
《中国医疗美容》
2025年第11期57-61,共5页
China Medical Cosmetology
关键词
乳腺癌
腔镜辅助下保留乳头乳晕全乳切除
假体植入
重建乳房
美学效果
安全性
breast cancer
endoscopic assisted total mastectomy with nipple sparing and areola preservation
prosthesis implantation
breast reconstruction
aesthetic effect
security
