乳腺及乳腺周围组织易位技术即刻修复乳腺癌保乳术后局部缺损:附87例报告

Immediate repair using mammary/perimammary tissue displacement technique for local defect after breast-conserving surgery

目的:探讨利用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损的临床应用价值。方法:回顾2009年1月—2012年1月应用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损的87例的临床资料,分析该术式的特点及临床适用情况,并评估其术后并发症及美观效果。结果:87例患者修复手术均取得成功,其中周围腺体组织瓣成形术61例,侧胸筋膜结缔组织皮瓣成形术12例,部分背阔肌皮瓣成形术14例。全组无严重并发症发生。术后经12～27个月随访,患者未出现局部复发,术后美观效果:优、良75例(86.1%),一般12例(13.7%);修复后乳房形态自然对称,手感良好。结论:利用乳腺及乳腺周围组织易位技术即刻修复保乳术后局部缺损,可避免乳房严重变形,能较好保持乳房外观及形态,是一种简单易行、安全可靠的术式,有较高的应用价值。

Objective： To investigate the clinical application value of immediate repair using mammary/perimammary tissue displacement technique for local defect after breast-conserving therapy. Methods： The clinical data of 87 breast cancer patients undergoing immediate repair using mammary/ perimammary tissue displacement technique during breast-conserving surgery between January 2009 and January 2012 were reviewed, q-he characteristics and clinical applicability of this technique were analyzed, and the postoperative complications and cosmetic results were assessed. Results： Repair operation was successfully performed in all the 87 patients, of whom, 61 cases underwent mammoplasty with adjacent gland tissue flap, 12 cases underwent mammoplasty with lateral thoracic fascial flap, and 14 cases underwent mammoplasty with partial latissimus dorsi muscle flap. There were no severe postoperative complications in any of the whole group of patients. Postoperative follow-up was 12 to 27 months and no local recurrence occurred. The cosmetic results were excellent or good in 75 （86.1%） cases, and fair in12 （13.7%） cases. The reconstructed breasts showed natural and symmetrical appearance with good hand-feeling. Conclusion： Application of immediate repair using mammary/perimammary tissue displacement technique for local defect during breast-conserving therapy can avoid serious breast deformation and maintain the dense breast appearance. This procedure is easy, safe and effective, and is of considerable clinical value.