乳腺癌术后乳房即刻再造152例报告

Breast reconstruction following mastectomy with implants report of 152 cases

目的探讨乳癌根治术后即时应用单纯假体植入、可调式双囊假体植入和自体组织移植乳房再造术的适应证及疗效。方法101例在保留皮肤的乳腺癌改良根治术基础上于胸大肌下方植入Mentor假体再造乳房,39例在胸大肌下方植入Becker可调式假体再造乳房,10例用单蒂下腹部横行腹直肌肌皮瓣移植至乳房缺损区再造乳房。2例采用扩大的背阔肌肌皮瓣移植再造乳房。结果随访152例3～65个月,中位时间28个月,2例13个月后肿瘤局部复发,取出假体。术后乳房外观评价优良率达94%。结论单纯假体植入适用于乳房较小的患者,可调式假体植入乳房再造适用于乳房较大,或根治术时皮肤缺损较多的患者。

Objective A review of the results obtained from a series of consecutive patients undergoing breast reconstruction following mastectomy with full-size implant, Becker expandable implant, pedicled transverse rectus abdominis musculocutaneous （TRAM） flap and extended latissimus dorsi musculocutanous flap （ELDF） to evaluate the indications, surgical methods and effects. Methods Immediate breast reconstructions were carried out using full-size Mentor implants following skin-sparing mastectomy in 101 patients and Becker expandable implants were used for immediate breast reconstruction in 39 patients. Unilateral pedieled TRAM flaps were used for immediate breast reconstruction in 10 and extended latissimus dorsi museulocutaneous flap （ELDF）was carried out in 2 patients. 65 months. Tumor was locally recurrent in 2 patients, Results The patients were followed in the past 3 - and the implant was carried out. Minor complications small local skin necrosis of nipple-areola complex and seroma formation. Satisfactory results than 94% of the patients. Conclusions Size implant is ideal for a slender, small-breast women. In patients with large breast or those who received modified mastectomy, expandable implants can be used for immediate breast reconstruction, which combines the merits of full-size implant methods and tissue expansion methods. TRAM or ELDF flap for breast reconstruction is a useful procedure with advantages of autologous tissue and excellent results and suitable for reconstruction, that can meet the basically requirement.