扩大乳晕缘合并微整形在巨大乳腺纤维腺瘤手术中应用.docVIP

扩大乳晕缘合并微整形在巨大乳腺纤维腺瘤手术中应用 　　1.上海交通大学医学院附属新华医院普外科、乳腺外科上海200092； 　　2.上海交通大学医学院胆道疾病研究所上海200092） 　　摘 要 目的：探讨扩大乳晕缘合并微整形技术在巨大乳腺纤维腺瘤手术中的临床效果。方法：收集2012至2014年巨大乳腺纤维腺瘤患者22例，采用沿乳晕（9例）或扩大乳晕（13例）的手术路径切除肿瘤，并通过乳晕成形术和腺体瓣转移微整形技术恢复局部腺体凹陷和避免乳头凹陷。结果： 22例患者术后乳房成形满意，随访3～16个月未发现乳头坏死和感觉障碍。结论：应用扩大乳晕缘合并腺体瓣转移微整形技术可以完整切除肿瘤，并避免腺体的局部和乳晕区的凹陷畸形，尤其适合乳晕较小、肿瘤较大患者。 　　关键词乳腺肿瘤乳晕成形术巨大乳腺纤维腺瘤微整形 　　中图分类号：R737.9文献标识码：A文章编号：1006-1533（2014）12-0006-04 　　Application of enlarged areola margin combined with micro plastic in the treatment of giant breast fibroadenoma 　　YE Yuanyuan1,2, CHEN Yuanyuan1,2, DU Zhiyong1,2, SONG Heping1,2, WANG Dengbin1,LIU Yingbin1,2, HAN Baosan1,2 　　(1.Department of General Surgery, Breast Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China，2.Institute of Biliary Tract Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China) 　　ABSTRACT Objective: To investigate clinical effect of enlarged areola margin combined with micro plastic in the treatment of giant breast fibroadenoma. Methods: Twenty-twopatients with giant breast fibroadenoma were underwent tumor resection with areola margin incision（n=9） or enlarged areola margin incision（n=13）between 2012 and 2014. Areola plastic and micro plastic of gland flaps transfer were used to repair the residual cavity after tumor resection. Results: Satisfactory shape of breast in 22 patients was maintained after surgery with no necrosis and sensory obstacle during follow-up period. Conclusion: The combination of enlarged areola margin incision and micro plastic of gland flaps transfer can be used in completely tumor resection and may avoid deformity of local glands and areola area. It is suitable for patients with smaller areola and larger tumor. 　　KEY WORDSbreast tumor; areola plastic; giant breast fibroadenoma; micro plastic 　　乳腺纤维腺瘤是女性乳房最常见的良性肿瘤，占所有良性肿瘤的3/4[1-2]，其中巨大乳腺纤维腺瘤占所有乳腺纤维腺瘤的0.5%～2%[3]，其增长迅速，特点为直径大于5 cm和（或）重量超过500 mg[4-5] ，目前多数文献以5 cm作为评定界限[6]。本病虽为良性肿瘤，但个别