乳腺癌术后胸壁转移的外科治疗

Surgical treatment of postoperative chest metastasis in patients with breast cancer

目的 探讨乳腺癌术后胸壁转移的外科治疗及方法。方法 1997年 6月～ 2 0 0 0年 12月手术治疗 30例乳腺癌术后胸壁转移瘤。胸壁肿物切除后行对侧乳腺劈裂瓣修补术 16例 ,行同侧腹直肌瓣修补术 6例 ,行大网膜瓣修补+中厚皮瓣植皮术 8例。术后予以CAF方案化疗 14例 ,NP方案化疗 16例。结果 术后皮瓣部分坏死 2例 ,均为大网膜瓣修补 +中厚皮瓣植皮术治疗病例 ,经清创再植皮而痊愈。全部病例均获得随访。术后肿瘤远处再发转移 5例 ,予以继续化疗获得缓解。结论 外科治疗使乳腺癌术后胸壁转移取得良好效果 ,提高患者的生活质量。

Objective To investigate the surgical treatment of postoperative chest metastasis in patients with breast cancer.Methods From June,1997 to December 2000,operation was performed on 30 cases of postoperative chest metastastic tumor from breast cancer. Among whom 16 were reconstructed with contralateral breast split flap,6 with rectus abdominis myoctutaneous flap,and 8 with flap of greater Omentum and intermediate split thickeness skin graft.All patients received chemotherapy after operation,14 cases receiving CAF and 16 receiving NP.Results 30 cases were interviewed and all are alive now except 2 cases of partially necrolysis,which appeared in the group with flap of greater Omentum and healed by necronectomy and replantation.After operation,5 cases recurred distantly and improved following chemotherapy.Conclusion It indicates that the surgical treatment is effective on the tumor of postoperative chest metastasis in patients with breast cancer and can improve the patients' quality of life