中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
4期
314-317
,共4页
乳腺肿瘤%外科,整形%保乳手术
乳腺腫瘤%外科,整形%保乳手術
유선종류%외과,정형%보유수술
Breast neoplasms%Surgery,plastic%Breast conservative surgery
目的 总结整形外科技术在乳腺癌保乳手术中应用的临床经验和术后美容效果.方法 回顾性分析2009年10月至2011年8月间采用整形外科技术完成的50例乳腺癌保乳手术的患者的临床资料.分析整形外科技术应用的条件、方法、并发症以及效果.结果 50例患者均为乳腺单发肿瘤,其中12例患者接受术前新辅助治疗,38例患者直接手术.肿瘤位于外上象限、内下象限、外下象限、乳头乳晕下方、乳头乳晕上方以及乳头乳晕附近与乳头乳晕深方的患者分别为20例、4例、7例、3例、7例以及6例与3例.采用的切口分别为放射状/水平状切口、V形切口、J形切口、倒T形切口、蝙蝠翼样切口以及双环切口与J形切口.术后出现2例乳腺内血肿,3例出现伤口裂开并继发感染,1例出现皮肤缺血坏死.35例患者完成辅助放化疗,有1例患者出现乳头位置偏移,2例患者出现切口处皮肤凹陷.其余患者的乳房外形均良好,患者对乳房外形的评分均较高.随访期限为4～27个月,2例患者出现局部复发,重新接受手术；其余患者均未出现复发.结论 乳腺癌保乳手术中应用整形外科技术可使部分特殊位置的肿瘤获得保乳机会,术后乳房外形保持满意.
目的 總結整形外科技術在乳腺癌保乳手術中應用的臨床經驗和術後美容效果.方法 迴顧性分析2009年10月至2011年8月間採用整形外科技術完成的50例乳腺癌保乳手術的患者的臨床資料.分析整形外科技術應用的條件、方法、併髮癥以及效果.結果 50例患者均為乳腺單髮腫瘤,其中12例患者接受術前新輔助治療,38例患者直接手術.腫瘤位于外上象限、內下象限、外下象限、乳頭乳暈下方、乳頭乳暈上方以及乳頭乳暈附近與乳頭乳暈深方的患者分彆為20例、4例、7例、3例、7例以及6例與3例.採用的切口分彆為放射狀/水平狀切口、V形切口、J形切口、倒T形切口、蝙蝠翼樣切口以及雙環切口與J形切口.術後齣現2例乳腺內血腫,3例齣現傷口裂開併繼髮感染,1例齣現皮膚缺血壞死.35例患者完成輔助放化療,有1例患者齣現乳頭位置偏移,2例患者齣現切口處皮膚凹陷.其餘患者的乳房外形均良好,患者對乳房外形的評分均較高.隨訪期限為4～27箇月,2例患者齣現跼部複髮,重新接受手術；其餘患者均未齣現複髮.結論 乳腺癌保乳手術中應用整形外科技術可使部分特殊位置的腫瘤穫得保乳機會,術後乳房外形保持滿意.
목적 총결정형외과기술재유선암보유수술중응용적림상경험화술후미용효과.방법 회고성분석2009년10월지2011년8월간채용정형외과기술완성적50례유선암보유수술적환자적림상자료.분석정형외과기술응용적조건、방법、병발증이급효과.결과 50례환자균위유선단발종류,기중12례환자접수술전신보조치료,38례환자직접수술.종류위우외상상한、내하상한、외하상한、유두유훈하방、유두유훈상방이급유두유훈부근여유두유훈심방적환자분별위20례、4례、7례、3례、7례이급6례여3례.채용적절구분별위방사상/수평상절구、V형절구、J형절구、도T형절구、편복익양절구이급쌍배절구여J형절구.술후출현2례유선내혈종,3례출현상구렬개병계발감염,1례출현피부결혈배사.35례환자완성보조방화료,유1례환자출현유두위치편이,2례환자출현절구처피부요함.기여환자적유방외형균량호,환자대유방외형적평분균교고.수방기한위4～27개월,2례환자출현국부복발,중신접수수술；기여환자균미출현복발.결론 유선암보유수술중응용정형외과기술가사부분특수위치적종류획득보유궤회,술후유방외형보지만의.
Objective To evaluate oncoplastic techniques on breast conservative surgery.Methods Clinical data of 50 breast cancer patients who received oncoplastic breast conservative surgery from October 2009 to August 2011 were retrospectively analyzed.The indication,methods,outcome and morbility of oncoplastic surgery were assessed. Results All patients had solitary tumors.Twelve patients received neoadjuvant therapy and thirty-eight received upfront surgical therapy.Different oncoplastic surgery techniques were applied based on the location of tumor.There were 20 tumors located in upper outer quadrant receiving lateral radial or horizontal excision; Four lower inner and seven lower outer tumors received V and J shape excision respectively; Three low pole and seven upper pole tumors received inverted T and batwing excision respectively; Six tumors located periareolar area and three tumors located retroareolar area were removed using round block and J shape excision.Two patients experienced postoperative hematoma and three patients had incisional dehiscence followed by secondary infection. Another developed skin ischemia and necrosis. Thirty-five patients have finished the postoperative adjuvant radiotherapy. The appearances of the breasts were satisfactory in all patients except one having deviation of nipple and two patients suffering from dimpling in incisional region.Patients gave high scores about their breast appearance.After 4- 27 months follow-up,two patients had local recurrence and received mastectomy.Other patients were free of recurrence. Conclusions Breast oncoplastic surgery technique benefits those whose tumors located in special area of the breast resulting in a satisfactory cosmetical appearance of the breast.
