乳腺癌术后乳房重建术式的选择

Study of methods of breast reconstruction after mastectomy for breast cancer patients

目的探讨如何选择乳腺癌手术后乳房重建的手术方法及效果分析。方法根据患者乳腺癌手术的具体方法及个体差异,选择转移下腹部横行腹直肌肌皮瓣、背阔肌肌皮瓣、腹壁下动脉穿支游离皮瓣或联合假体乳房重建158例。结果转移下腹部横行腹直肌肌皮瓣乳房重建93例,其中即刻乳房重建65例(满意率为95.38%),延期乳房重建28例(满意率为92.86%)。背阔肌肌皮瓣或联合假体乳房重建59例,满意率为96.61%。腹壁下动脉穿支游离皮瓣乳房重建3例,满意率为100%。假体植入乳房重建3例,满意率为100%。结论乳腺癌手术后选择适当乳房重建的手术方法十分重要;根据个体差异选择不同乳房重建术式,使重建的乳房更加逼真,达到令人满意的效果。

Objective To study the methods of breast reconstruction after mastectomy for breast cancer patients. Methods 158 cases underwent breast reconstruction, either with TRAM flap or with latissimus dorsi flap with/without implants, according to breast size, shape, local treatment of breast cancer and desire of the patient. Results All patients were followed up from 1 to 74 months. In the TRAM flap group, the satisfaction rate was 95.38% for immediate breast reconstruction （65 cases） and 92. 86% for delayed breast reconstruction （28 cases）. In the latissimus dorsi flap with/without implant group （59 cases）, the satisfaction rate is 96.61%. Conclusions It is important to choose an appropriate method for breast reconstruction, which could make the reconstructed breast symmetry to normal breast and improve the quality of life.