肿瘤整形技术在早期乳腺癌保乳手术中的临床应用

发布时间：2018-03-16 07:28

本文选题：乳腺肿瘤　切入点：乳房切除术　出处：《中国普通外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨肿瘤整形技术应用于早期乳腺癌保乳术的疗效及安全性。方法:回顾性分析2011年8月—2016年8月139例应用肿瘤整形技术进行保乳手术治疗的I~II期乳腺癌患者临床资料,并与同期1 271例行乳腺癌改良根治术的I~II乳腺癌患者的远期效果比较。结果:139例患者中,133例采用体积易位技术(局部腺体组织瓣转移修补法)进行保乳手术,其中45例同时接受对侧缩乳术,6例采用体积置换技术(自体组织移植修补法);78例行前哨淋巴结活检术,61例接受腋窝淋巴结清扫术。139例乳腺癌患者切除组织标本重30~187 g,平均69.5 g;美容效果评定结果为优秀79例(56.8%)、良好47例(33.8%)、一般10例(7.2%)、差3例(2.2%)。术后随访时间为3~63个月,平均28.8个月;与行改良根治术的患者比较,行肿瘤整形保乳术患者的术后2年局部复发率(4.3%vs.4.1%),总生存率(95.7%vs.95.5%),无病生存率(85.6%vs.85.3%)均无统计学差异(均P0.05)。结论:应用肿瘤整形技术对早期乳腺癌进行保乳手术具有较好的肿瘤学安全性和满意的美容效果,远期效果与改良根治术相当。选择适合的病例和合理的整形技术,是肿瘤整形保乳术取得最佳的术后效果的关键。
[Abstract]:Objective: to evaluate the efficacy and safety of tumor plastic surgery in the treatment of early breast cancer. Methods: the clinical data of 139 patients with stage II breast cancer undergoing breast conserving surgery from August 2011 to August 2016 were retrospectively analyzed. The results were compared with that of 1 271 patients undergoing modified radical mastectomy in the same period. Results among 139 cases of breast cancer, 133 cases were treated with volume translocation technique (local glandular tissue flap transfer and repair) for breast conserving operation. Among them, 45 cases received contralateral mammary constriction and 6 cases underwent volume replacement (autologous tissue transplantation and repair method 78 cases sentinel lymph node biopsy 61 cases received axillary lymph node dissection .139 cases of breast cancer patients resected tissue weight. The results of beauty evaluation were excellent 79 cases (56.8%), good 47 cases (33.8%), average 10 cases (7.2g) and 3 cases (2.2g). The follow-up time was 3 ~ 63 months. Mean 28.8 months; compared with patients undergoing modified radical mastectomy, The local recurrence rate of patients undergoing plastic surgery and breast conserving surgery was 4.3vs.4.1. The overall survival rate was 95.7vs.95.50.There was no statistical difference in the disease-free survival rate of 85.6v s.85.3.Conclusion: it is better to use tumor plastic surgery in early breast cancer surgery. Safety and satisfactory cosmetic effects of oncology, The long-term effect is the same as that of modified radical mastectomy. The key to obtain the best postoperative effect is to select suitable cases and reasonable plastic techniques.
【作者单位】：重庆市肿瘤研究所乳腺中心;
【基金】：重庆市医学科研计划基金资助项目(20141018)
【分类号】：R737.9

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