“人”字型腺体组织瓣肿瘤整形技术在早期乳腺癌保乳术中的应用

Clinical application of“人”-shaped glandular tissue oncoplastic technique in breast-conserving surgery for early breast cancer

目的探讨“人”字型腺体组织瓣肿瘤整形技术在早期乳腺癌保乳手术中的临床效果和安全性。方法回顾性分析2017年3月至2019年12月于本院行乳腺癌保乳术且接受“人”字型腺体组织瓣肿瘤整形技术的78例女性患者的临床资料,分析其临床效果及并发症。结果手术时间65~175 min,平均时间98 min;术中切除组织体积47~214 mm^3,平均124.3 mm^3;其中有2例患者术中初次冷冻病理检查结果示切缘阳性,再次切取切缘行术中冷冻病理检查及术后石蜡病理检查均证实为阴性;2例患者因肿瘤病灶位于乳头乳晕区且术中近乳头侧切缘阳性而切除乳头乳晕复合体。术后3个月患者对乳房美容效果的满意度评价非常满意71例(91.0%)、满意6例(7.7%),一般1例(1.3%),无不满意患者,总体满意率为98.7%。术后3个月专科医师对乳房美容效果客观评分,其中优秀69例(88.5%),良好8例(10.3%),一般1例(1.3%)。术后共3例患者出现并发症,其中术后切口感染1例,局部皮下积液1例,乳头乳晕部分缺血1例,并发症发生率为3.8%,均经对症处理后痊愈,未延迟术后辅助治疗。结论“人”字型腺体组织瓣肿瘤整形保乳技术术后并发症发生率较低且获得满意的术后美容效果。

Objective To investigate the clinical effect and safety of“人”-shaped glandular tissue flap oncoplastic technique in breast-conserving surgery for early breast cancer.Methods The clinical data of 78 female patients who received breast-conserving surgery using“人”-shaped glandular tissue flap oncoplastic technique from March 2017 to December 2019 were analyzed retrospectively,and its clinical effects and complications were summarized and analyzed.Results The duration of operation was 65-175 min,with an average time of 98 min;the volume of tissue resected tissue was 47-214 mm^3,with an average of 124.3 mm^3;the incisal margins of 2 patients showed positive results in the initial cryophistopathological examination,but the incisal margins were confirmed to be negative in intraoperative cryophistopathological examination and postoperative paraffin pathological examination after next resection;2 patients were removed the nipple-areola complex because the tumor was located in the nipple and areola areas,and incisal margins were positive.In the evaluation of patients'satisfaction with breast cosmetic effect 3 months after operation showed that 71 patients(91.0%)were very satisfied,6 patients(7.7%)were satisfied,1 patient(1.3%)was general and no dissatisfied patients were found,with an overall satisfaction rate of 98.7%.In the objective evaluation by specialists with breast cosmetic effect 3 months after operation showed that there were 69 excellent cases(88.5%),8 good cases(10.3%),and 1 general case(1.3%).Postoperative complications occurred in a total of 3 patients,including 1 case of postoperative incision infection,1 case of local subcutaneous,and 1 case of partial nipple and areola ischemia,the complication rate was 3.8%,and all recovered after symptomatic treatment without delay of postoperative adjuvant treatment.Conclusions The breast-conserving surgery using“人”-shaped glandular tissue flap oncoplastic technique has a low incidence of postoperative complications and a satisfactory cosmetic effect.