13例单切口腔镜辅助下扩展型背阔肌乳房重建术患者临床分析

Clinical analysis of 13 cases of single incision endoscopic-assisted enlarged latissimus dorsi musculocutaneous breast reconstruction

目的:探讨单切口腔镜辅助下即刻扩展型背阔肌乳房重建术的可行性及优势。方法:2015年11月至2017年8月在蚌埠医学院第一附属医院肿瘤外科行单切口扩展型背阔肌肌皮瓣乳房重建的13例早期乳腺患(Ptis患者2例,PT1患者7例,PT2患者4例),随访观察患者手术效果及该手术优势。结果:13例患者均成功经乳房外上象限行小切口手术,切口长度约8 cm,腔镜辅助下扩展型背阔肌乳房重建术,1例患者出现血清肿(7.69%);1例患者因乳头乳晕复合体后方腺体术中冰冻切片检查为阳性,切除乳头及乳晕,术后再造乳房外形饱满,与对侧基本对称(7.69%);8例患者评价为优(61.54%),2例患者评价为良(15.38%),2例患者评价为一般(15.38%),1例患者评价为差(7.69%);所有患者均获随访8～45个月,无一例局部复发及远处转移。结论:单切口乳腺癌根治联合腔镜辅助下即刻扩展型背阔肌乳房重建术,在实际应用中是安全的,技术可行,具有很好美容效果。

Objective:To explore the feasibility and advantages of the single incision endoscopic-assisted enlarged latissimus dorsi musculocutaneous breast reconstruction.Methods:Retrospective analysis was performed on 13 patients(Ptis:n=2;PT1:n=7;PT2:n=4)with early breast cancer in the First Affiliated Hospital of BengBu Medical College from November 17,2015 to August 21,2017.All of them experienced the single incision endoscopic-assisted enlarged latissimus dorsi musculocutaneous breast reconstruction.The effects,feasibility and advantage were evaluated in the observation and follow-up.Results:All the 13 patients were successfully treated(average length of incision of about 8 cm).1 patient(7.69%)experienced seroma;1 patient(7.69%)was removed the nipple and areola(because of the positive test result of nipple areola complex glands during frozen section examination),and the reconstructive breast appearance was full and the contralateral basic symmetric;8 patients(61.54%)were evaluated as the optimal,2 patients(15.38%)were evaluated as the good,2 patients(15.38%)were evaluated as the general,and 1 patient(7.69%)was evaluated as the poor.All the patients were followed up for 8-45 months.No local recurrence and distant metastasis happened.Conclusion:The practical application of the single incision endoscopic-assisted enlarged latissimus dorsi musculocutaneous breast reconstruction is safe and technically feasible,with good cosmetic effect and less trauma.