应用多方位腺体瓣一期修复乳腺癌保乳术后乳房缺损

发布时间：2018-06-04 08:40

本文选题：乳腺癌 + 保乳术　；参考：《广东医学》2017年12期

【摘要】：目的探讨应用多方位腺体瓣一期修复乳腺癌保乳术后乳房缺损的可行性及美容效果。方法对29例乳腺癌患者,先按常规方法实施保乳术,接着利用原乳腺切口形成多方位腺体瓣。将周围缺损的腺体从胸大肌表面分离,再于腺体断面浅层作水平剖开,形成多个不同方位的腺体瓣,包括两侧的腺体瓣及中央的腺体瓣。根据周围缺损的腺体条件不同,形成腺体瓣长宽可不同,然后将腺体瓣向瘤床滑行推进,尽可能使其无张力对合或叠加,并缝合固定。术后给予化疗、放疗和内分泌治疗等综合治疗。结果 29例实施保乳的乳腺癌患者,术后恢复良好,美容评定达到优良乳房美容效果者为23例(79.3%),一般者为6例(20.7%),无美容效果差的患者。随访3~48个月,无复发转移,外形变化不明显,患者满意。结论应用多方位腺体瓣一期修复乳腺癌保乳术后乳房缺损,美容效果满意,具有简单易行、不增加额外瘢痕、并发症少,可耐受放疗等优点,但不适合于小乳房或低密度腺体类型的患者。
[Abstract]:Objective to investigate the feasibility and cosmetic effect of multi-directional glandular flap for breast defect after breast conserving operation. Methods 29 patients with breast cancer were treated with conserving breast according to the routine method, and then multidirectional glandular flap was formed by the original mammary incision. The surrounding glands were separated from the surface of the pectoralis major muscle and then opened horizontally in the superficial layer of the gland section to form a number of glandular valves in different directions including both sides of the glandular flap and the central glandular flap. According to the different glandular conditions around the defect, the length and width of the glandular flap may be different, and then the glandular flap will glide to the tumour bed, making it as tensionless as possible, involute or superposed, and sutured and fixed. Postoperative chemotherapy, radiotherapy and endocrine therapy and other comprehensive treatment. Results 29 cases of breast cancer with breast conserving were recovered well after operation. 23 cases with excellent breast beauty effect were assessed as good breast beauty, 6 cases with normal breast conserving mammary cancer, and 6 cases with normal breast cancer. There were no patients with poor cosmetic effect. Follow-up for 3 ~ 48 months showed no recurrence and metastasis. Conclusion the application of multi-directional glandular flap in the primary repair of breast defect after breast conserving surgery is satisfactory, simple and easy to carry out, no extra scar, less complications, and can withstand radiotherapy. However, it is not suitable for patients with small breasts or low density glands.
【作者单位】：深圳市妇幼保健院乳腺科;
【分类号】：R737.9

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