皮瓣内固定在乳腺癌改良根治术中的应用

A Clinical Study of Skin-flap Quilting Fixation in Modified Radical Mastectomy

目的探讨皮瓣垂直褥式缝合内固定在乳腺癌改良根治术中的临床应用价值。方法回顾性分析2016年1月—2018年12月在我科行乳腺癌改良根治术的118例患者的病例资料,分为56例皮瓣固定组及62例皮瓣无固定组。比较两组患者的手术时间、术后总引流量、拔管时间、皮瓣坏死率及血清肿发生率。结果两组的手术时间、皮瓣坏死例数差异无统计学意义(P>0.05)。皮瓣固定组的总引流量为(324.50±70.09)mL,拔管时间为(15.41±4.16)天,血清肿发生率为12.50%,皮瓣无固定组的总引流量为(377.42±91.49)mL,拔管时间为(18.68±5.52)天,血清肿发生率为29.03%,两组在术后总引流量、拔管时间及血清肿的发生对比上均差异有统计学意义(P<0.05)。结论皮瓣褥式缝合内固定可有效减少乳腺癌改良根治术后血清肿的发生,且并未增加术后其他并发症。

Objective To investigate the clinical value of skin-flap quilting fixation in modified radical mastectomy.Methods We reviewed retrospectively 118 breast cancer patients undergoing modifi ed radical mastectomy in the Department of Thyroid and Breast Surgery of Changshu No.2 People’s Hospital from Jan 2016 to Dec 2018.Of these patients,56 underwent skin-fl ap quilting fi xation and 62 without fi xation.Operation time,total volume of drainage,extubation time,rate of skin-flap necrosis,rate of CSS(clinically significant seroma)between the two groups were compared.Results There was no significant difference in operation time and number of skin-flap necrosis cases(P<0.05).Total volume of drainage,extubation time,rate of CSS were(324.50±70.09)mL,(15.41±4.16)day,12.50%in skin-flap flaxtion group,and these observations in no fixation group were(377.42±91.49)mL,(18.68±5.52)day,29.03%,respectively.There were significant differences in total volume of drainage,extubation time and rate of CSS between the two groups.Conclusion Skin-flap quilting fixation can effectively decrease seroma formation after modified radical mastectomy,and does not increase surgical complications.