假体在即刻乳房重建术中的应用

The application of silicone prosthesis in the immediate breast reconstruction

目的探讨假体在即刻乳房重建术中的应用价值。方法回顾性分析2012年1月至2017年6月期间于笔者所在医院接受即刻假体乳房重建的42例乳腺肿瘤患者的临床资料(其中有6例乳腺恶性叶状肿瘤患者),总结术后重建乳房的美容效果及并发症发生情况。结果本组患者的手术顺利,手术时间为230～435 min(平均325 min),术中出血量为100～160 mL(平均130 mL),住院时间为18～33 d(平均24 d)。术后外观评价:优26例,良8例,差8例,优良率为81.0%(34/42);患者对重建乳房的总体满意度为73.8%(31/42),美学满意度为78.6%(33/42)。术后出现血清肿2例,3例乳头乳晕部分皮肤发生缺血坏死。本组所有患者均获访,随访时间为4～70个月,中位随访时间为37个月。随访期间,患者无局部复发和远处转移发生;6例接受了放射治疗的患者中有2例出现Ⅱ度包膜挛缩。结论即刻假体乳房重建术是一种操作简便、并发症轻、易处理且效果良好的手术方法。

Objective To evaluate the feasibility of immediate breast reconstruction with silicone prosthesis for breast tumor. Methods The clinical data of the 42 patients with breast tumor who had undergone breast reconstruction with silicone prosthesis from January 2012 to June 2017 were collected retrospectively. The postoperative complications and cosmetic results were analyzed. Results All patients underwent operation successfully. The surgical time was230–435 min（mean of 325 min）, the intraoperative blood loss was 100–160 mL（mean of 130 mL）, and the hospitalization time was 18–33 d（mean of 24 d）. The cosmetic results was excellent in 26 patients, good in 8 patients,bad in 8 patients, and fine rate was 81.0%（34/42）. Rate of patients＇ overall satisfaction with breast reconstruction was73.8%（31/42） and rate of aesthetic satisfaction was 78.6%（33/42）. After operation, seroma occurred in 2 patients, and the ischemic necrosis in nipple and areola occurred in 3 patients. All the patients were followed-up for 4–70 months,and the median follow-up time was 37 months. During the follow-up period, no patient had metastasis or recurrence.Six patients received radiotherapy, among them 2 patients appeared Ⅱ-grade capsular contracture. Conclusion The breast reconstruction with silicone prosthesis is a simple, easy, and effective surgical procedure.