摘要
目的探索硅胶假体联合钛化聚丙烯补片(TCPM)在乳腺癌即刻乳房重建中的应用效果。方法收集2018年8月至2021年10月厦门大学附属中山医院乳腺外科对可手术乳腺癌行保留乳头乳晕全乳切除术及硅胶假体联合TCPM即刻乳房重建术的23例患者的临床资料,对其手术方式和安全性、术后并发症、美容效果及远期随访结果进行回顾性分析。结果 23例患者手术过程顺利,其中经下皱襞切口11例,外上象限放射状切口12例。平均时间(133.60±5.30)min,平均出血出血(72.50±17.60)mL,术后引流管拔除平均时间(15.70±3.30)d。重建乳房美学满意率为91.30%(21/23)。术后23例患者有不同程度的乳头感觉障碍,随术后时间的延长有所恢复。8例术后出现不同程度的乳头表皮坏死,后期坏死表皮脱落后出现局部色素脱落,均未导致明显乳头轮廓畸形。2例术后切口处脂肪液化,经充分引流及加强局部换药后好转。1例术后5个月术区局部皮瓣感染,经全身抗感染治疗后好转。1例术后皮下积液,经超声引导局部穿刺抽液及加压包扎后好转。1例因排斥反应取出假体及网片。经随访2-39个月,未发现复发、转移,包膜挛缩,假体移位。结论假体联合补片在乳腺癌术中乳房即刻重建的应用是可行的。
Objective To explore the clinical effect of silicone prosthesis combined with titanium polypropylene mesh(TCPM) in breast reconstruction.Methods The clinical data of 23 patients with breast cancer who underwent mastectomy with nipple areola and silicone breast implant combined with TCPM immediate breast reconstruction in the breast surgery department of Xiamen University Hospital in Zhongshan from August 2018 to October to 2021 were retrospectively analyzed. The operative methods and safety, postoperative complications, cosmetic results and long-term follow-up results were retrospectively analyzed. Results The operation process of 23 patients was smooth, including 11 cases of lower plica incision and 12 cases of radial incision in outer upper quadrant.The average time was(133.60±5.30) min, the average bleeding was(72.50±17.60) mL, and the average time of drainage tube removal was(15.70±3.30) days. The aesthetic satisfaction rate of reconstructed breast was 91.30%(21/23). After operation, 23 patients had different degrees of nipple sensory disturbance, which recovered with the extension of postoperative time. 8 cases had different degrees of papillary epidermal necrosis after operation, and local pigment abscission after necrotic epidermal abscission in the later stage, which did not lead to obvious papillary contour deformity. Fat liquefaction at the incision in 2 cases improved after full drainage and strengthening local dressing change. One case had local flap infection 5 months after operation and improved after systemic anti infection treatment. One case of postoperative subcutaneous effusion improved after ultrasound-guided local puncture, fluid extraction and pressure bandage.Prosthesis and mesh were removed in 1 case due to rejection. After follow-up for 2-39 months, no recurrence, metastasis, capsule contracture and prosthesis displacement were found. Conclusion The application of prosthetic patch in breast reconstruction is feasible.
作者
徐鹰妮
孟敏君
XU yingni;MENG Minjun(Department of Breast Surgery,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361000,China)
出处
《中国医药指南》
2021年第34期7-10,共4页
Guide of China Medicine
关键词
乳腺癌
手术治疗
乳房重建
假体联合补片
Breast cancer
Surgical treatment
Breast reconstruction
Prosthesis combined patch
