关于保留乳头、乳晕的乳腺癌改良根治术后假体植入即刻乳房再造.docx

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关于保留乳头、乳晕的乳腺癌改良根治术后假体植入即刻乳房再造

【摘要】目的探讨保留乳头、乳晕及部分乳房皮肤的乳腺癌改良根治术后假体植入即刻乳房再造的具体方法、术后效果及可行性。方法筛选出病理及癌肿位置符合要求的5例Ⅰ、Ⅱ期的乳腺癌患者，实施乳头、乳晕及部分乳房皮肤保留的乳腺癌改良根治术，同时采用硅胶充填假体置入乳房重建，另行术后个体化综合治疗。结果5例乳腺癌患者即时乳房再造全部成功，未出现皮瓣坏死，双侧乳房基本对称，乳房形态良好，患者心理状态及社会适应性较好。术后随访4~52个月，所有病例均无局部复发和远处转移。美容效果：良2例，中2例，差1例。结论合理选择患者行保留乳头、乳晕及部分乳房皮肤的乳腺癌根治术后，即刻进行假体植入乳房再造，手术操作简便，安全可靠，两次手术一次完成，减轻患者心理压力和缺陷，减少患者痛苦和经济负担，易被接受，术后不影响乳腺癌的辅助治疗和远期疗效，适宜于在基层医院大力发展及广泛推广。

【关键词】乳腺癌改良根治术;假体植入;乳房再造

[Abstract]ObjectiveToinvestigatespecificsurgicalmethodsandeffectandfeasibilityofimmediatebreastreconstructionwithprosthesisimplantandaftermodifiedradicalmastectomyofbreastcancerwithnipple-areolarcomplexpreservationandpartialskin-sparing.MethodsFromNovember2006toOctober2010，5breastcancerpatientswhomeettherequirementsreceivednipple-sparingmodifiedradicalmastectomyplusaxillarylymphnodedissectionandimmediatebreastreconstructionwithprosthesisimplant，afterinpidualcomprehensivetreatment.ResultsAllreconstructionsweresuccessful.Breastformisgoodandthetwosidesseemedsymmetricalandnoskinflapnecrosis.Patientspsychologicalstatusandsocialadaptabilityisgood.Nonepatientoflocalrecurrenceanddistantmetastasiswasfound.Cosmeticeffect:goodin2cases，generalin2cases，poorin1case.ConclutionImmediatebreastreconstructionwithprosthesisimplantaftermastectomyofbreastcancerwithpreservationofnipple-areolarcomplexandpartialskin-sparingissafeandeffectiveforearlystagebreastcancerpatients.Breastreconstructionsurgeryiseconomicalandcanreducepatients’psychologicalpressureduetolossofthebreast，andimprovequalityoflife.Immediatebreastreconstructiondoesnotaffectpostoperativeadjuvanttherapyandlong-termtherapeuticeffect.Breastreconstructionsurgeryhasbeengraduallyacceptedbymoreandmoreearlystagebreastcancerpatients.Thismethodshouldbeacceptedforthebasichospita