环乳晕切口与放射状切口对乳腺癌患者保乳术后瘢痕愈合及并发症的影响

Effect of circumareolar incision and radial incision on scar healing and complications after breast-conserving surgery in breast cancer patients

目的探讨环乳晕切口与放射状切口对乳腺癌患者保乳术后瘢痕愈合及并发症的影响。方法将101例乳腺癌患者根据不同的手术方式分为环乳晕切口组(n=51)和放射状切口组(n=50),对照组采用放射状切口手术治疗,观察组采用环乳晕切口手术治疗。比较两组患者围术期相关指标、神经功能恢复情况、瘢痕愈合情况、复发情况和并发症发生情况。结果环乳晕切口组患者手术时间明显长于放射状切口组(P﹤0.01),术中出血量明显高于放射状切口组(P﹤0.01),但其瘢痕长度明显小于放射状切口组(P﹤0.01)、住院时间明显短于放射状切口组(P﹤0.01)。环乳晕切口组患者触觉和痛觉恢复时间均短于放射状切口组,差异均有统计学意义(P﹤0.05)。环乳晕切口组患者并发症总发生率为13.73%(7/51),低于放射状切口组的32.00%(16/50),差异有统计学意义(χ^(2)=4.794,P=0.029)。术后1、3、6个月,环乳晕切口组患者温哥华瘢痕量表(VSS)评分均低于放射状切口组,差异均有统计学意义(P﹤0.05)。环乳晕切口组患者治疗满意度为92.16%(47/51),明显高于放射状切口组的72.00%(36/50),差异有统计学意义(χ^(2)=7.004,P=0.008)。环乳晕切口组患者总复发率为9.80%(5/51),放射状切口组为6.00%(3/50),差异无统计学意义(P﹥0.05)。结论相较于放射状切口,环乳晕切口可缩短乳腺癌保乳术患者手术瘢痕长度和住院时间,促进神经功能恢复和瘢痕愈合,且并发症相对较少,患者满意度较高。

Objective To compare the effect of circumareolar incision and radial incision on scar healing and complications after breast-conserving surgery in breast cancer patients.Method A total of 101 breast cancer patients were divided into circumareolar incision group(n=51,treated with circumareolar incision)and radial incision group(n=50,treated with radial incision)according to the surgical methods.Perioperative indicators,neurological function recovery,scar healing,recurrence and complications were compared between the two groups.Result The operation time and intraoperative blood loss in circumareolar incision group were significantly higher than those in radial incision group(P<0.01),but the scar length and hospital stay were significantly lower than those in radial incision group(P<0.01).The recovery time of touch and pain sensation in circumareolar incision group was significantly shorter than that in radial incision group(P<0.05).The incidence of complications in circumareolar incision group was 13.73%(7/51)significantly lower than that 32.00%(16/50)in radial incision group(χ^(2)=4.794,P=0.029).The vancouver scar scale(VSS)score of circumareolar incision group was significantly lower than that of radial incision group at 1,3 and 6 months after operation(P<0.05).The treatment satisfaction of ring areola incision group was 92.16%(47/51)higher than 72.00%(36/50)of radial incision group(χ^(2)=7.004,P=0.008).There was no significant difference for the overall incidence of recurrence in two groups[9.80%(5/51)vs 6.00%(3/50),P>0.05].Conclusion Compared with radial incision,circumareolar incision can shorten surgical scar length and hospital stay,promote neurological recovery and scar healing,with relatively fewer complications and high patient satisfaction in breast cancer patients undergoing breast-preserving surgery.