摘要
目的探讨乳房再造手术同期行对侧乳房对称性整形手术的方法及近期疗效。方法 2014年2月-2015年12月,对6例乳腺癌术前患者及5例乳腺癌保留乳头乳晕的乳房切除术后患者,在乳房再造术中(即刻及延期)同期行对侧乳房对称性整形手术。患者年龄36~55岁,平均45岁。乳腺癌术前患者病程7 d^6个月,中位时间2个月;肿瘤分期:T_(is)N_0M_0 2例,T_1N_0M_0 3例,T_2N_0M_0 1例。乳腺癌术后患者于术后2~25年,平均8年入院。11例患者均采用保留乳头乳晕的乳房切除术,乳房再造术应用假体乳房再造术7例,背阔肌肌皮瓣乳房再造术4例;对侧乳房对称性整形手术中6例采用假体植入隆乳术,5例采用乳房缩小术。结果术后1例出现乳房切口边缘局部愈合不良,给予换药治疗,脱痂后伤口延期愈合;其余患者伤口均Ⅰ期愈合,未出现伤口感染,假体感染、移位、外露、包膜挛缩等并发症。术后11例均获随访,随访时间3~24个月,平均12个月。末次随访时根据患者自身及整形外科专科医师对双侧乳房对称和美观的评价,优9例,良2例,优良率100%。随访期间患者均未出现肿瘤复发及转移。结论根据患侧乳房再造的方式及乳房外形,乳房再造术同期行对侧乳房对称性整形手术,避免了二次手术,能够取得满意疗效。
Objective To explore the techniques and short-term effectivness of contralateral breast symmetrization mammaplasty in breast reconstruction. Methods Between February 2014 and December 2015, 11 patients received immediate or delayed breast reconstruction after nipple-sparing mastectomy （6 and 5 cases respectively） for contralateral breast symmetrization mammaplasty. The age ranged 36-55 years （mean, 45 years）. The disease duration was from 7 days to 6 months （mean, 2.5 months） in 6 patients undergoing immediate breast reconstruction. According to tumor TNM staging, 2 cases were rated as TisNoM0, 3 cases as T1N0M0, and 1 case as T2N0M0. The duration was from 2 to 25 years （mean, 8 years） in 5 patients undergoing delayed breast reconstruction. The implant （7 cases） and latissimus dorsi （4 cases） were used for breast reconstruction; and breast augmentation （6 cases） and breast reduction （5 cases） were performed for contralateral breast symmetrization. Results One patient had local poor wound healing postoperatively and was cured; primary healing was obtained in the other patients, and no other postoperative complication of infection, implant exposure or capsular contracture was found. The patients were followed up 3 to 24 months （mean, 12 months）. The reconstructive outcomes were excellent in 9 cases and good in 2 cases, with an excellent and good rate of 100%. There was no recurrence or metastasis. Conclusion Simultaneous contralateral symmetrization with augmentation^reduction mammaplasty after breast reconstruction can obtain satisfactory symmetric outcomes.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2016年第10期1253-1257,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
北京大学人民医院研究与发展基金(RDC2014-27)~~
关键词
乳房再造
乳腺癌
乳房对称性整形手术
乳房缩小术
隆乳术
Breast reconstruction
Breast cancer
Breast symmetrization mammaplasty
Breast reduction
Breastaugmentation
