论文部分内容阅读
目的总结在外侧象限乳腺癌保乳术后采用部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣重建乳房的效果。方法 2012年9月—2016年9月,收治18例外侧象限乳腺癌女性患者。年龄41~65岁,平均46.5岁。浸润性导管癌17例,黏液腺癌1例。均为单发肿物,直径2.5~4.0 cm,距离乳头乳晕3~5 cm。患者乳房体积均为中-小型。保乳术后应用部分背阔肌皮瓣(13例)或侧胸壁脂肪筋膜皮瓣(5例)重建乳房。术后均行放疗。结果术后1例出现部分侧胸壁脂肪筋膜皮瓣坏死合并感染,其余皮瓣均顺利成活。16例切口Ⅰ期愈合,2例出现血清肿,穿刺抽液及加压包扎后Ⅱ期愈合。术后患者均获随访,随访时间6~50个月,平均26.8个月。术后6个月参照Kim等标准评价乳房重建效果,优12例、良4例、一般2例。随访期间未出现局部复发及远处转移。结论外侧象限乳腺癌保乳术后应用侧胸壁手术切口联合部分背阔肌皮瓣或侧胸壁脂肪筋膜皮瓣重建乳房,可以获得满意的美容效果。
Objective To summarize the effects of partial latissimus dorsi flap or side fascia flap on reconstruction of the breast after lateral breast conserving surgery. Methods From September 2012 to September 2016, 18 patients with lateral quadrant breast cancer were treated. Aged 41-65 years old, average 46.5 years old. Invasive ductal carcinoma in 17 cases, mucinous adenocarcinoma in 1 case. Are single tumor mass, diameter 2.5 ~ 4.0 cm, distance nipple areola 3 ~ 5 cm. Patients breast size are medium - small. After breast-conserving surgery, part of the latissimus dorsi flap (13 cases) or the side wall of the fat fascia flap (5 cases) reconstruction of the breast. Postoperative radiotherapy. Results One case had postoperative necrosis of fat flap on the fascia of the chest wall and the other flaps survived successfully. Sixteen incisions healed in the first stage, two cases had seroma, puncture fluid and healed after the second dressing. Postoperative patients were followed up for 6 to 50 months with an average of 26.8 months. Six months after surgery, Kim et al evaluated the effect of breast reconstruction based on the criteria of Kim et al. The results were excellent in 12 cases, good in 4 cases, and fair in 2 cases. During follow-up, no local recurrence and distant metastasis occurred. Conclusion Lateral quadrant breast cancer after breast-conserving surgery with the application of lateral thoracic surgical incision or part of the latissimus dorsi flap or side fascia flap reconstruction breast, you can get a satisfactory cosmetic results.