双侧乳房切除术后即刻植入物乳房重建:腔镜与传统开放手术的比较

Direct-to-implant breast reconstruction after bilateral mastectomy:A comparison between endoscopic and conventional open surgery

目的比较双侧腔镜下乳房重建与开放乳房重建的临床效果差异。方法回顾性分析2017年1月—2021年1月在华西医院乳腺外科住院行双侧乳房移植物重建28例女性患者的临床资料。按手术方式分为腔镜组12例,年龄(41.3±8.9)岁,开放组16例,年龄(41.6±8.8)岁。比较两组患者的临床资料。结果两组患者人口学、肿瘤学资料差异无统计学意义(P>0.05),两组患者植入物差异有统计学意义(P=0.008)。两组患者手术时间[(298.2±108.6)min vs.(326.5±95.8)min,P=0.480]和麻醉时间[(373.4±91.2)min vs.(400.3±97.1)min,P=0.463]差异无统计学意义。开放组较腔镜组总并发症(P=0.035)及主要并发症(P=0.024)多,差异有统计学意义。乳房满意度、社会心理健康及性健康方面,腔镜组术后6个月和1年的评分高于开放组(P<0.05)。结论腔镜重建手术安全有效,在对乳房满意度、生活质量的满意度方面较高,比传统开放手术更优越。

Objective To compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction.Methods The clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively.The patients were divided into two groups:an endoscopic group(n=12,aged41.3±8.9 years)and an open group(n=16,aged 41.6±8.8 years).The clinical data of the two groups of patients were compared.Results There was no significant difference in demographic and oncological data between the two groups(P>0.05).There was a significant difference in the implants between the two groups(P=0.008).The operation time(298.2±108.6 min vs.326.5±95.8 min,P=0.480)and anesthesia time(373.4±91.2 min vs.400.3±97.1 min,P=0.463)were not significantly different.The total complications(P=0.035)and major complications(P=0.024)in the open group were more than those in the endoscopic group.For the comparison of breast satisfaction,psychosocial well-being and sexual well-being,the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group(P<0.05).Conclusion The endoscopic reconstruction is safe and effective,with high satisfaction rates regarding breast reconstruction and quality of life,and is superior to conventional open surgery.