双环S型法设计乳腺癌手术切口的应用

The application of the double circular "S"-shaped incision in breast cancer

目的:观察在应用Stewart切口的基础上,探讨乳腺癌手术切口采用改良的双环S型法在减少乳腺癌病人术后并发症中的价值。方法:对157例乳腺癌病人,分别采用梭型切口(对照组)和双环S型法(实验组)进行手术治疗。观察术后病人的皮瓣坏死、皮下积液及肩关节活动恢复等术后并发症情况,并进行局部复发率和生存率比较。结果:采用双环S型法手术的乳腺癌病人,其皮瓣坏死率较低,肩关节功能恢复较好,18个月中位随访期(12～36个月)中局部复发率为6.6%。结论:双环S型法设计的切口可较好地保留正常的皮肤,减小皮瓣张力,减少术后并发症,提高乳腺癌病人的术后生存质量。

Objective The effect of double circular ＂S＂-shaped incision （modified on the basis of Stewart incision） in reducing the postoperative complications of breast cancer patients. Methods A total of 157 cases with breast cancer were randomly divided into two groups： the spindle-shaped incision group （control group） and the double circular ＂S＂-shaped incision group （experimental group）. The skin flap necrosis, seroma under skin flap and the recovery of shoulder joint activity were observed after the operation. The local recurrence rate and the survival rate have been analyzed. Results The rate of skin flap necrosis and the relay in shoulder joint function recovery in the experimental group were obviously lower than that of the control group. The local recurrence rate was 6.6% at a median follow-up period of 18 months （the range is 12-36 months）. Conclusions The double circular ＂S＂-shaped incision produces less complications in the skin flap and improves the life of quality in the patients.