乳腺癌改良根治术Ⅰ期扩大背阔肌肌皮瓣乳房再造

Modified radical mastectomy-stage Ⅰ expansion of latissimus dorsi muscle flap breast reconstruction

背景与目的:乳腺癌手术治疗给患者带来的形体残损和心理创伤已成为临床医生和患者越来越关心的问题,越来越多的乳腺癌患者有接受乳房重建尤其是Ⅰ期重建的意愿。本研究旨在探讨一种既达到肿瘤根治性切除,又保留乳房美观外形的乳房再造的手术方法。方法:2006年1月—2007年4月共收治早期乳腺癌患者15例。所有患者均行扩大背阔肌肌皮瓣再造乳房的手术治疗,手术过程中,保留乳房皮肤,切除乳腺组织并对腋窝淋巴结进行清扫。结果:术后评价优11例(73.3%),良4例(26.7%)。结论:保留皮肤乳腺癌根治术后即时乳房再造,切口隐蔽,再造乳房形态效果好,对早期乳腺癌患者是一种安全可行的治疗方法。

Background and purpose： Physical and psychological trauma has been a challenge for both clinician and patients with breast cancer after modified radical mastectomy, and now more and more patients have begun to accept breast reconstruction, especially I stage reconstruction after surgery. The aim of our study was to investigate a breast reconstruction procedure that can not only achieve radical tumor excision but also retain the aesthetic appearance of breast. Methods： 15 patients from January 2006 to April 2007 were enrolled with early stage breast cancer have received surgical treatment with conservation of breast skin, breast tissue excision and axillary lymph nodes; latissinms dorsi muscle flap has been used for breast reconstruction. Results： The results of the 15 cases： excellent in 11 cases （83. 3%）, good in four cases （ 16.7%）. Conclusions： Immediate breast reconstruction after radical mastectomy with conservation of skin has shown good results in terms of aesthetic appearance of breast, this procedure has been proved to be a safe and feasible method of treatment for the patients with early stage breast cancer.