| 饶彬,杨华伟.保留乳头乳晕早期乳腺癌切除加背阔肌肌皮瓣 I期乳房重建术 32例临床观察[J].安徽医药,2019,23(10):2005-2010. |
| 保留乳头乳晕早期乳腺癌切除加背阔肌肌皮瓣 I期乳房重建术 32例临床观察 |
| Immediate latissimus dorsi myocutaneous flap breast reconstruction after nipple?sparing mastectomy for early breast cancer:a clinical study of 32 cases |
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| DOI：10.3969/j.issn.1009?6469.2019.10.025 |
| 中文关键词: 乳腺肿瘤 乳房成形术 乳房切除术，改良根治性 外科皮瓣 保留乳头乳晕 背阔肌肌皮瓣 |
| 英文关键词: Breast neoplasms Mammaplasty Mastectomy,modified radical Surgical flaps Nipple areola sparing Latis?simus dorsi myocutaneous flap |
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| 中文摘要: |
| 目的探索保留乳头乳晕的早期乳腺癌切除加背阔肌肌皮瓣 Ⅰ期乳房重建术的可行性及治疗效果。方法回顾性分析广西医科大学附属肿瘤医院 2013年 3月至 2017年 6月期间收治的，接受保留乳头乳晕的乳房皮下腺体切除联合前哨淋巴结活检或腋窝淋巴结清扫术加背阔肌肌皮瓣 Ⅰ期乳房重建术的早期乳腺癌病人(乳房重建组) 32例临床病理资料，同时根据肿瘤最大径，肿瘤边缘到乳头乳晕距离，腋窝淋巴结转移个数，激素受体及 HER2情况配对后按 1∶1选配同期接受患侧乳房单纯切除联合前哨淋巴结或者腋窝淋巴结清扫术的早期乳腺癌病人(全乳房切除组) 32例。比较两组病人术后并发症、术后拔管时间、术后乳房外形美容程度、术后生命质量及短期局部复发转移率等方面来分析两组病人的治疗效果。结果乳房重建组与全乳房切除组皮下积液发生率分别为 18.75%比 12.50%(χ2＝0.474，P＝0.491)皮瓣坏死发生率分别为 9.38%比 6.25%(χ2＝ 0.000，P＝1.000)，切口感染发生率分别为 3.13%比 0.00%(P＝1.000)，切口愈合不，良发生率分别为 3.13%比 3.13%(χ2＝0.000， P＝1.000)，两组患者患肢均无活动障碍，乳房重建组在皮下积液、皮瓣坏死和切口感染率与常规手术组比较差异无统计学意义( P＞0.05)；在术后拔管时间上乳房重建组长于全乳房切除组，分别为( 17.29±8.79)d比( 9.81±3.16)d(P＝4.530，P＝0.000)，差异有统计学意义( P＜0.05)乳房重建组术区愈合时间长于常规手术组。两组患者术后乳房外形美容程度评价中，乳房重建组优为 17例，良为 10例，一般为，5例，无外形差病例，优良率达到 84.38%，全乳房切除组外形均评价为差，乳房重建组术后乳房外形美容评价明显优于全乳房切除组( P＜0.05)。同时乳房重建组病人术后生命质量评价中优于全乳房切除组( P＜0.05)。乳房重建组和全乳房切除组中位随访时间分别为 28和 27个月，乳房重建组局部和全乳房切除组复发率为 3.13%比 3.13%(χ2＝ |
| 英文摘要: |
| Objective To explore the feasibility and effect of immediate latissimus dorsi myocutaneous flap breast reconstruction af?ter nipple?sparing mastectomy for early breast cancer.Methods Retrospective analysis was made about the clinical data of 32 pa?tients who underwent latissimus dorsi flap breast reconstruction after nipple?sparing subcutaneous mastectomy combined with senti?nel lymph node biopsy or axillary lymph node dissection(breast reconstruction group)from March 2013 to June 2017 in The Affili? ated Cancer Hospital of Guangxi Medical University.Another 32 patients with early breast cancer(mastectomy group)who under? went simple resection of the affected breast combined with sentinel or axillary lymph node dissection during the same period wereselected by 1∶1 according to the maximum diameter of the tumor，the distance from the edge of the tumor to the nipple areola，the number of axillary lymph node metastasis，hormone receptor and HER2.By comparing the two groups of patients in postoperative complications，postoperative extubation time，postoperative breast cosmetics，postoperative life quality and short?term local recur? rence and distant metastasis rate，the therapeutic efficacies of the two groups were analyzed.Results The incidence of subcutane? ous effusion in breast reconstruction group and total mastectomy group was 18.75% vs.12.50%(χ2＝0.474，P＝0.491)，the inci? dence of skin flap necrosis was 9.38% vs.6.25%(χ2＝0.000，P＝1.000)，the incidence of incision infection was 3.13% vs.0.00%(P＝ |
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