胸大肌包裹假体置入一期乳房重建在保留皮肤乳癌根治术中应用.docVIP

胸大肌包裹假体置入一期乳房重建在保留皮肤乳癌根治术中应用[摘要]目的:探讨保留皮肤的乳腺癌改良根治术一期胸大肌包裹假体置入乳房重建的可行性。方法:对28例0、I、II期乳腺癌患者行保留皮肤的乳腺癌改良根治术后,同期于胸大肌后方置入硅胶假体重建乳房,并根据冰冻切片检查结果决定是否保留乳头乳晕复合体。结果:28例早期乳腺癌患者均保留了乳头乳晕复合体,术后随访2～18个月,外观良好,双侧乳房对称,优良率达96.5%。所有病例均无局部复发或远处转移,无明显术后并发症。结论:保留皮肤的乳腺癌改良根治术后用硅胶假体行一期乳房重建,能达到满意的乳房美容效果,是治疗早期乳腺癌安全可行的方法。 [关键词]乳腺癌改良根治术;假体;乳房重建 [中图分类号]R737.9[文献标识码]A[文章编号]1008-6455(2010)06-0815-03 Skin-sparing mastectomy combined breast reconstruction immediately by subpectoral implantation of a prosthesis REN Min,WANG Ben-zhong,WANG Jin, PEI Jing, XU Xiao-jun, YAN Yun-wen (Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China) Abstract: 0bjectiveTo explore the feasibility of immediate breast reconstruction with subpectoral implantation of silicone gel prothesis after skin-sparing modified radical mastectomy. Methods A total of 28 patients of 0,I,II stage breast cancer underwent skin-sparing modified radical mastectomy. Over the same period,breast reconstruction had been completed with inserting silicone gel prosthesis subpectoralis.Results All 28 patients’ nipple-areola complex were conserved. Postoperative follow-up 2～18 months,Bilateral breast were symmetry, good appearance. Excellent and good rate was 96.5%.No local recurrence or distant metastasis. No obvious complications occurred. ConclusionImmediate breast reconstruction with subpectoral implantation of silicone gel prothesis after skin-sparing modified radical mastectomy is proven to be an effective and safe method with the advantage of good appearance, shorter recovery time in earlier breast cancer. Key words:modified radical mastectomy;prosthesis;breast reconstruction 乳腺癌改良根治术后所致的乳房缺失,不但破坏女性形体完美,而且对患者身心造成严重影响。所以部分患者希望得到一种既能治愈疾病又不损伤自身形体治疗方法。目前由于乳腺癌综合治疗手段的进步,术后患者生存率提高,同时术式的不断改良,尤其是保留皮肤的乳癌改良根治术(skin-sparing modified mastectomy),为乳癌术后乳房重建,尤其是即刻乳房重建提供了更为有利的条件。近两年来,我们对28例早期乳腺癌开展了保留皮肤的乳腺癌改良根治术后假体植入即刻乳房重建术,效果良好,现介绍如下。 1资料和方法 1.1 一般资料:本组28例中,年龄35～68岁(中位年龄42岁)。右侧16