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目的:探讨乳腺癌患者行腺体全切除联合一期乳房重建的术前、术中评估及具体实施。方法:对近2年行保留皮肤及保留乳头乳晕复合体(NAC)的乳腺癌切除术联合一期重建患者,术前完善数字化乳腺机及MRI,CT等检查,术中完善病理学检查,术后完善重建乳房美学及患者满意度评估并随访。结果:9例患者成功保留NAC,1例因肿瘤切缘与乳晕距离小于2 cm,切除NAC,行保留皮肤的乳腺癌切除术;9例采用假体植入一期重建,1例假体联合背阔肌皮瓣一期重建,术后随访1～24个月,患者主客观评价好,未出现局部复发及远处转移。结论:严格掌握乳腺癌腺体全切除联合一期乳房重建的适应证,操作简单易行,手术治疗美容效果佳,无严重不良并发症,不影响乳腺疾病的治疗。
Objective: To investigate the preoperative and intraoperative evaluation and implementation of total gland excision combined with primary breast reconstruction in patients with breast cancer. Methods: In the past two years, patients undergoing breast cancer resection combined with one-stage reconstruction with retained skin and retained nipple-areola complex (NAC) were examined with digitalized mammography and MRI and CT before operation. The pathological examination was performed during surgery After the perfect reconstruction of breast aesthetics and patient satisfaction assessment and follow-up. Results: NAC was successfully retained in 9 patients, breast resection was performed in 1 patient whose tumor margins and areola were less than 2 cm. NAC was excised and the skin was preserved. Nine patients underwent reconstruction with a prosthesis, After a period of 1 to 24 months, the patients were evaluated subjectively and objectively without local recurrence and distant metastasis. Conclusion: Strict mastery of total excision combined with a breast reconstruction indications, the operation is simple, good cosmetic effect of surgery, no serious adverse complications, does not affect the treatment of breast disease.