球拍形切口乳房成形术在早期乳腺癌保乳手术中的应用

Application of racquet-shaped incision mammoplasty in breast-conserving surgery for early-stage breast cancer patients

目的对比分析球拍形切口乳房成形术与传统保乳术在早期乳腺癌治疗中的临床效果。方法选取2019年1月—2020年12月在嘉兴市第二医院本部及南湖分院就诊的早期乳腺癌患者84例,使用随机数字表法将其分为实验组和对照组,各42例。实验组采用球拍形切口乳房成形术,对照组采用传统保乳术,比较2组患者术后美容效果、手术时间、术中出血量、切除标本体积、血清肿形成率、第1次切缘阳性率、术后切口感染率及全乳切除率。结果实验组术后美容效果优良率为90.5%,高于对照组的61.9%,差异有统计学意义(P<0.01)。实验组切除标本体积为(89.4±23.1)mL,大于对照组的(67.7±23.9)mL,差异有统计学意义(P<0.01)。实验组2例(4.8%)患者发生血清肿,少于对照组的19例(45.2%),差异有统计学意义(P<0.01)。实验组2例(4.8%)患者第1次切缘阳性,少于对照组的8例(19.0%),差异有统计学意义(P<0.05)。2组手术时间、术中出血量、切口感染率及全乳切除率差异无统计学意义(均P>0.05)。中位随访时间为25个月,2组均未出现局部复发病例,实验组和对照组各有1例患者出现远处转移,2组远处转移率差异无统计学意义(P>0.05)。结论在早期乳腺癌保乳手术中使用球拍形切口乳房成形术较传统保乳术可改善术后美容效果,减少血清肿发生,降低第1次切缘阳性率,值得推广应用。

Objective To compare the clinical efficacy of racquet-shaped incision mammoplasty and traditional breast-conserving surgery for early-stage breast cancer.Methods A total of 84 patients with early-stage breast cancer at the Second Hospital of Jiaxing and its Nanhu Branch from January 2019 to December 2020 were divided into experimental and control groups according to the random number table method,42 cases in each group.The experimental group was treated with racquet-shaped incision mammoplasty,and the control group was treated with traditional breast-conserving surgery.The cosmetic effect,operation time,intraoperative blood loss,resected volume,rate of seroma,rate of positive margins in first resection,rate of infection and rate of mastectomy were compared between the two groups.Results An excellent to good rate of cosmetic effect was observed in the experimental group,with a value of 90.5%,which was higher than that of the control group(61.9%,P<0.01).The resected volume in the experimental group was(89.4±23.1)mL,which was larger than that in the control group[(67.7±23.9)mL,P<0.01].The rate of seroma in the experimental group was 4.8%(2 cases),which was lower than that in the control group(45.2%,19 cases,P<0.01).The rate of positive margins in the first resection of the experimental group was 4.8%(2 cases),which was lower than that of the control group(19.0%,8 cases,P<0.05).No significant difference was observed in operative time,intraoperative blood loss,rate of infection and rate of mastectomy between the two groups(all P>0.05).The mean follow-up period was 25 months.All patients were free of local recurrence.There was 1 case of distant metastasis in each group,and there was no significant difference in the rate of distant metastasis between the two groups(P>0.05).Conclusion For early-stage breast cancer,racquet-shaped incision mammoplasty can improve breast aesthetics after operation and reduce the rates of seroma and positive margins in the first resection compared with traditional breast-conserving surgery.It is worth popularizing and applying.