乳腺肿瘤切除术后二期组织扩张术假体植入乳房再造术的临床效果

Clinical efficacy of delayed tissue expanding breast reconstruction with implants

目的探讨乳腺肿瘤切除术后二期行组织扩张术假体植入乳房再造术的优缺点及临床效果。方法针对已行乳腺肿瘤手术患者，先通过放置圆形扩张器扩大皮肤覆盖量，二期再行扩张器取出，硅凝胶假体植入乳房再造术，必要时再行自体脂肪移植术进行后期调整。结果乳腺肿瘤切除术后二期行组织扩张术假体植入乳房再造术15例，平均扩张时间5．1个月，除有1例因在术后远期出现包膜挛缩而行假体取出，假体重新植入术之外，其他未出现明显包膜挛缩、皮肤破溃、假体移位或旋转等并发症。结论乳腺肿瘤切除术后二期行组织扩张术假体植入乳房再造术，能减少肿瘤复发或放疗的影响，适应证广，且减少皮瓣法带来的供区损伤及受区“补丁样”外观，是一种理想的乳房再造方法。

Objective To present the clinical effect of the delayed tissue expanding breast recon struction with implants. Methods For those who received breast tumor surgeries, round-shaped ex- pander was implanted for increasing skin coverage and silicone implant was used for breast reconstruc- tion after several months＇ expanding. Results 15 relevant cases were included in this study with an av- erage of 5.1 months expanding period. Only one patient received reoperation for capsular contraeture and there was no complication in the other cases. Conclusions Delayed tissue expanding breast recon- struction with implants, with a wide indication, is an ideal reconstructive method which can reduce the interference of tumor recurrence and radiotherapy and avoid the trauma of donor site and the patchqike appearance of breast.