CAJ | 학술논문

目的探讨保乳术后继发乳房畸形的原因及预防方法,以及根据乳房畸形的不同程度采用不同方法进行修复重建的治疗效果.方法选择行乳腺癌保乳术后1年以上,化疗及放疗结束半年以上,无局部复发及远位转移,患侧乳房出现继发畸形,要求修复重建患者30例,对患侧乳房进行瘢痕切除、挛缩松解,并根据组织缺损的不同程度,选择不同的方法进行修复重建,7例应用局部乳腺瓣法,21例应用背阔肌肌皮瓣法,2例采用横行腹直肌肌皮瓣法.结果术后乳房形态及手感良好,优23例(76.7％),良7例(23.3％).术后所有患者平均随访约2.5年,目前均处于无瘤生存状态.结论保乳术后继发乳房畸形,可根据畸形不同程度,选择不同方法进行修复重建,修复重建后乳房形态良好.
목적 탐토보유술후계발유방기형적원인급예방방법,이급근거유방기형적불동정도채용불동방법진행수복중건적치료효과.방법 선택행유선암보유술후1년이상,화료급방료결속반년이상,무국부복발급원위전이,환측유방출현계발기형,요구수복중건환자30례,대환측유방진행반흔절제、련축송해,병근거조직결손적불동정도,선택불동적방법진행수복중건,7례응용국부유선판법,21례응용배활기기피판법,2례채용횡행복직기기피판법.결과 술후유방형태급수감량호,우23례(76.7％),량7례(23.3％).술후소유환자평균수방약2.5년,목전균처우무류생존상태.결론 보유술후계발유방기형,가근거기형불동정도,선택불동방법진행수복중건,수복중건후유방형태량호.
Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.