游离大网膜即刻乳房重建术在乳腺癌术后乳房再造中的应用效果探讨

Application of Free Omentum Immediate Breast Reconstruction in Postoperative Reconstruction after Breast Cancer Surgery

目的:探讨游离大网膜即刻乳房重建术在乳腺癌术后乳房再造中的应用效果。方法:选取2016年9月-2019年9月于医院就诊的乳腺癌患者25例,均行局部切除保乳术及游离大网膜即刻乳房重建术。记录患者重建效果、手术情况、并发症情况、随访情况及生存质量评分。结果:治疗后,优16例(64.00%),良6例(24.00%),一般2例(8.00%),差1例(4.00%),优良率为88.00%(22/25)。患者术中出血量(60.86±11.49)ml,手术时间(177.21±10.35)min,引流时间(9.14±2.03)d,住院时间(13.48±2.72)d,术后生存质量总分为(108.14±10.15)分。患者术后大网膜均成活,无切口积液、感染、皮肤坏死、腹腔脏器受损、肠梗阻等明显并发症,无需二次手术,仅1例出现轻度肿胀,经临床护理后肿胀消失。术后随访时间6~24个月,平均(17.89±5.36)个月,患者均无肿瘤复发或转移。结论:游离大网膜即刻乳房重建术在乳腺癌术后修复中具有良好的应用效果,安全性高,并发症少,可提高生存质量,值得临床推广应用。

Objective To investigate the application effect of free omentum immediate breast reconstruction in postoperative reconstruction after breast cancer surgery.Methods Total of 25 patients with breast cancer who were treated in our hospital from September 2016 to September 2019 were selected.All patients underwent local resection to conserve breast surgery and immediate breast reconstruction with free omentum.The results of breast reconstruction,operation index,complications,follow-up and score of quality of life were recorded.Results After treatment,16 cases were excellent (64.00%),6 cases were good (24.00%),2 cases were general (8.00%),and one case were poor (4.00%),the excellent and good rate was 88.00% (22/25).The intraoperative blood loss was (60.86±11.49)ml,the operation time was (177.21±10.35)min,the drainage time was (9.14±2.03)d,the hospital stay was (13.48±2.72)d,and the total postoperative score of quality of life was (108.14±10.15) points.The omentum was alive after the operation,and there were no obvious complications such as incision effusion,infection,skin necrosis,abdominal organ damage,intestinal obstruction,and there was no need for a second operation.Only one case had a slight hematoma,which disappeared after clinical nursing.The postoperative follow-up time was 6 to 24 months,with an average of (17.89±5.36) months,and there was no tumor recurrence or metastasis.Conclusion Free omentum immediate breast reconstruction has a good application effect in the postoperative repair of breast cancer.It has high safety,few complications,and can improve the quality of life,which is worthy of clinical application.