CAJ | 학술논문

背景：在根治肿瘤的同时如何保持女性乳房的形态完美这一问题得到了越来越多医生及患者的关注，乳房再造由此而产生、发展，逐渐成为乳腺癌治疗的重要组成部分。目的：探讨乳腺癌改良根治术后即刻背阔肌肌皮瓣移植重建乳房的可行性及疗效。方法：纳入42例女性单侧乳腺癌患者，均进行保留乳头乳晕或保留乳房的改良根治术，术后即刻自体背阔肌皮瓣或扩大背阔肌肌皮瓣移植重建乳房，根据客观标准及主观标准评价重建效果。结果与结论：42例中，33例行保留乳头乳晕的乳腺癌改良根治术、9例行保留皮肤的乳腺癌改良根治术，背阔肌乳房重建24例、扩大背阔肌乳房重建18例。转移皮瓣及重建的乳房全部成活，无严重并发症发生。客观评价美容效果优良39例，一般3例；主观评价优良者40例，尚可者2例。随访9-41个月，所有患者无肿瘤局部复发，1例出现骨转移。表明乳腺癌改良根治术后即刻采用背阔肌移植重建乳房操作简单、易行，整形效果好，安全性高，成活率高。
배경：재근치종류적동시여하보지녀성유방적형태완미저일문제득도료월래월다의생급환자적관주，유방재조유차이산생、발전，축점성위유선암치료적중요조성부분。목적：탐토유선암개량근치술후즉각배활기기피판이식중건유방적가행성급료효。방법：납입42례녀성단측유선암환자，균진행보류유두유훈혹보류유방적개량근치술，술후즉각자체배활기피판혹확대배활기기피판이식중건유방，근거객관표준급주관표준평개중건효과。결과여결론：42례중，33례행보류유두유훈적유선암개량근치술、9례행보류피부적유선암개량근치술，배활기유방중건24례、확대배활기유방중건18례。전이피판급중건적유방전부성활，무엄중병발증발생。객관평개미용효과우량39례，일반3례；주관평개우량자40례，상가자2례。수방9-41개월，소유환자무종류국부복발，1례출현골전이。표명유선암개량근치술후즉각채용배활기이식중건유방조작간단、역행，정형효과호，안전성고，성활솔고。
BACKGROUND:How to keep the intact shape of the breast while treating tumor has been widely concerned by more doctors and patients, breast reconstruction is introduced, developed and considered an important part in the treatment of breast tumors. OBJECTIVE:To explore the feasibility and therapeutic effects of immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation. METHODS:We retrospectively analyzed the clinical and pathological features of 42 breast cancer patients under immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap or extended latissimus dorsi musculocuraneous flap. The procedure duration, postoperative complications and cosmetic outcome were assessed. RESULTS AND CONCLUSION:Among the involved 42 patients, 33 cases underwent modified radical mastectomy, retaining the nipple and areola of breast, 9 cases underwent modified radical mastectomy, retaining the skin of breast, 24 cases underwent breast reconstruction with latissimus dorsi musculocuraneous flap, 18 cases underwent breast reconstruction with extended latissimus dorsi musculocuraneous flap. The skin flap and reconstructed breast al survived, without severe complications. According to objective evaluation results, the cosmetic outcome was good in 39 cases and fair in 3 cases. The subjective evaluation results were good in 40 cases and fair in 2 cases. Al the patients were fol owed up for 9-41 months. One patient had bone metastasis 19 months after operation and there was no case with local recurrence. Immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap is a simple and feasible operation process, with optimal effects, high security, and high survival.