CAJ | 학술논문

目的评价采用乳房皱襞下带蒂脂肪瓣修复乳腺癌保乳手术后缺损的疗效.方法自2009年5月至2011年7月对天津医科大学附属肿瘤医院18例乳腺癌患者行保留乳房的局部广泛切除术,随后采用乳房皱襞下带蒂脂肪瓣修复局部缺损.全组均为女性,年龄33 ～ 59岁(中位43岁),肿瘤均位于乳房下方象限,最大径为2.0 ～3.0 cm(平均2.5 cm),术后给予全乳放射治疗及辅助化疗,并对其中10例雌激素受体阳性的患者行内分泌治疗.术后第1个月、辅助化疗完成后及全乳放疗后门诊各随访1次,观察手术后局部美容效果及放化疗对局部的影响,观察双侧乳房是否对称、有无水肿、坏死或瘢痕挛缩等情况,以后每4个月门诊随访1次观察局部复发及美容效果.结果全组18例脂肪瓣全部成活,术后中位随访15个月,全部无病生存.2例出现脂肪液化,全乳放射治疗对脂肪瓣未见明显影响,乳房外观优良率88.9％,患者主观评价满意度为100.0％.结论采用乳房下皱襞带蒂脂肪瓣修复保乳手术后的局部缺损可以获得满意的治疗效果和美容效果.
목적 평개채용유방추벽하대체지방판수복유선암보유수술후결손적료효.방법 자2009년5월지2011년7월대천진의과대학부속종류의원18례유선암환자행보류유방적국부엄범절제술,수후채용유방추벽하대체지방판수복국부결손.전조균위녀성,년령33 ～ 59세(중위43세),종류균위우유방하방상한,최대경위2.0 ～3.0 cm(평균2.5 cm),술후급여전유방사치료급보조화료,병대기중10례자격소수체양성적환자행내분비치료.술후제1개월、보조화료완성후급전유방료후문진각수방1차,관찰수술후국부미용효과급방화료대국부적영향,관찰쌍측유방시부대칭、유무수종、배사혹반흔련축등정황,이후매4개월문진수방1차관찰국부복발급미용효과.결과 전조18례지방판전부성활,술후중위수방15개월,전부무병생존.2례출현지방액화,전유방사치료대지방판미견명현영향,유방외관우량솔88.9％,환자주관평개만의도위100.0％.결론 채용유방하추벽대체지방판수복보유수술후적국부결손가이획득만의적치료효과화미용효과.
Objective To evaluate the cosmetic outcomes of applying pedicle fat flap below breast fold for repairing inferior quadrant defect in breast-conserving surgery.Methods From May 2009 to July 2011,18 cases of breast cancer at our hospital were recruited.All cases underwent breast-conserving procedures and achieved negative margin by frozen section examination.Then pedicle fat flap below breast fold was applied to reshape breast defect.All of them were of females with a median age of 43 years (range:33-59).The median tumor size was 2.5 cm (range:2.0-3.0).All tumors were located at the inferior quadrant of breast.All of them received whole breast radiotherapy and adjuvant chemotherapy.And 10 cases with positive estrogen receptor had adjuvant endocrine therapy.They were followed up at one-month postoperatively.Upon the completion of chemotherapy and radiotherapy,then follow-up was once every 4 months.The cosmetic outcomes and disease relapse were observed.Results All pedicle fat flaps survived without necrosis.After a median follow-up period of 15 months,all survived disease-free.Fat liquefaction was observed in 2 cases.The whole breast radiotherapy had no significant effect on pedicle fat flap.The rate of good cosmetics was 88.9％.And their subjective satisfactory rate was 100.0％.Conclusion Both satisfactory aesthetic outcome and good efficacy are obtained with pedicle fat flap below breast fold for tumors located at the inferior quadrant of breast.