箭形皮瓣法在乳腺癌术后乳头再造术中的应用

Postoperative effect of arrow-shaped flap in nipple reconstruction for breast cancer

目的 评价箭形皮瓣乳头在乳腺癌术后乳头再造术中的应用效果。方法 回顾性分析2019年1月至2020年12月在广西医科大学附属肿瘤医院行箭形皮瓣乳头再造的5例患者的临床资料。分别于术后即刻、6个月、12个月对乳头存活率、并发症、乳头直径及凸度保持情况、患者满意度进行评价。结果 5例患者中,仅1例乳头切口愈合延迟,其余患者术区一期愈合,与健侧对称性较好。其中3例患者接受术后综合治疗,2例患者仅接受化学治疗,乳头再造手术均在放化疗结束 3~6个月后进行,术后未见乳头坏死、瘢痕增生、供区延迟愈合等并发症。随访13~24个月,平均(17.2±4.2)个月。术后即刻、6个月、12个月再造乳头平均凸度分别为(14.8±2.3)mm、(11.5±1.7)mm、(8.2±1.5)mm,术后6个月、12个月乳头凸度回缩率分别为(22.2±4.2)%、(44.8±3.9)%,患者满意度为非常满意1例,满意3例,基本满意1例。结论 箭形皮瓣设计简单,易于操作,术后并发症发生率低,患者满意度较高,值得临床推广。

Objective To evaluate the postoperative effect of arrow-shaped flap nipple reconstruction for breast cancer.Methods This retrospective study included 5 patients who underwent arrow-shaped flap nipple reconstruction in the Affiliated Tumor Hospital of Guangxi Medical University from January after 2019 to December 2020.The nipple survival rate,postoperative complications,nipple diameter and projection maintenance,and patient surgery satisfaction were evaluated immediately,6 months,and 12 months.Results Among the 5 patients,only 1 case had delayed healing of the nipple incision,while the remaining patients had primary healing in the surgical area,with good symmetry with the healthy side.Three patients received comprehensive postoperative treatment,while two patients only received chemotherapy.Nipple reconstruction surgery was performed 3 to 6 months after the end of radiotherapy and chemotherapy,and no complications such as nipple necrosis,scar hyperplasia,or delayed healing of the donor site were observed after surgery.Follow up for 13 to 24 months,with an average of(17.2±4.2)months.The average convexity of reconstructed nipples immediately,6 months,and 12 months after surgery was(14.8±2.3)mm,(11.5±1.7)mm,and(8.2±1.5)mm,respectively.The nipple convexity retraction rates at 6 months and 12 months after surgery were(22.2±4.2)%and(44.8±3.9)%.The patient satisfaction levels(very satisfied,satisfied,basically satisfied)were 1 case,3 cases,and 1 case respectively.Conclusions The arrow-shaped flap is simple in design,easy to operate,has a low incidence of postoperative complications,and high patient satisfaction,and is worthy of clinical promotion.