保留乳头乳晕乳腺癌术后即刻乳房再造15例

Immediate breast reconstruction in 15 patients after nipple-sparing mastectomy for breast cancer

目的探讨保留乳头乳晕乳腺癌改良根治术后即刻采用背阔肌乳房再造的可行性。方法 2007年5月~2010年1月,对15例年龄为31~45岁（平均38岁）的乳腺癌患者行保留乳头乳晕乳腺癌改良根治术后即刻采用背阔肌乳房再造。对手术时间、术后并发症和美学效果进行评估。结果平均手术时间270 min,再造乳房全部成活,无严重的并发症发生。美容效果优良13例、尚好2例,无外形差的病例。5例术后出现背部供区血清肿,2例乳头部分坏死。术后所有患者对乳房形态均满意。结论对早期乳腺癌行保留乳头乳晕乳腺癌改良根治术后即刻采用背阔肌乳房再造是可行的。该方法操作简便,术后并发症少,再造乳房形态良好,它同时满足了肿瘤治疗和形体美容两个方面的要求,是早期乳腺癌患者一种安全有效的手术方式。

Objective To explore the therapeutic effects of immediate breast reconstruction after nipple-sparing mastectomy with latissimus doris flap for early breast cancer patients.Methods From May 2007 to January 2010,15 breast cancer patients aged 31～45 years（median 38 years） underwent immediate breast reconstruction after nipple-sparing mastectomy.with latissimus doris flap.The procedure duration,postoperative complications and cosmetic outcome were assessed.Results The mean procedure duration was 270 min and there was no flap loss and no sever complications,The cosmetic outcome was good in thirteen,fair in two,and there were no poor cases of the patients.There were 5 cases of doral seromas and 2 cases of nipple necrosis.Satisfactory cosmetic results were achieved in all patients.Conclusion Immediate breast reconstruction after nipple-sparing mastectomy with latissimus doris flap is a safe and effective method for early stage breast cancer patients.The procedure is easily perfomed with good cosmetic outcome.