保留乳头乳晕改良根治术同期TRAM瓣乳房再造治疗早期乳腺癌的近期疗效

Short term effect of modified radical operation for preserving nipple - areolar and simultaneous breast reconstruction using trans- verse rectus abdominis myocutaneous flap for early breast cancer

目的：观察保留乳头乳晕复合体的乳腺癌改良根治术同期应用下腹部横行腹直肌肌皮瓣（TRAM瓣）转移乳房再造治疗早期乳腺癌（Ⅰ、Ⅱa期）的近期疗效。方法：本组56例早期乳腺癌患者，治疗组26例进行保留乳头乳晕的改良根治术同时应用TRAM乳房再造；对照组30例行乳腺癌改良根治术。两组在手术时间、引流时间、引流量、术后并发症及外观方面进行比较。结果：所有56例患者均获随访，随访时间12～62个月（平均26个月）。26例保留乳头乳晕的改良根治术同期乳房再造均获成功，除1例患者出现部分皮瓣血运欠佳外，其余均无并发症。治疗组再造乳房效果良好，两组均无癌局部复发或远处转移。结论：保留乳头乳晕的乳腺癌改良根治术同期应用TRAM乳房再造治疗早期乳腺癌（Ⅰ、Ⅱa期）安全可行，可同时满足肿瘤治疗和形体美两方面的要求，提高了患者的生活质量。

Objective： To evaluate the short term effcet of modified radical operation for preserving nipple - areolar and simultaneous breast reconstruction using transverse rectus abdominis myocutaneous flap（TRAM） for early breast cancer（Ⅰ、Ⅱa）. Methods： Of 56 early breast cancer, 26 patients were performed modified radical masteclomy combined with breast reconstruction with TRAM, and compare with 30 patients who were modified radical mastectomy. Results： Twenty - six patients of modified radical mastectomy for preserving nipple - areolar and simultaneous breast reconstruction using TRAM were successful in which 1 case was poor blood supply of the partial flap, others recovered without complications. All the 56 patients had no recurrence or metastasis of breast cancer, and the reconstructed breast had excellent or good configuration after following up for 12 - 62 months（ mean 29 months）. Conclusion： Modified radical mastectomy combined with early breast reconstruction with TRAM is safe and effective treatment and shape beauty, which improves the patient＇s quality of life.