摘要
目的探讨新辅助化疗对乳腺癌切除假体植入Ⅰ期乳房重建术后并发症及远期疗效的影响。方法接受乳腺癌切除+假体植入Ⅰ期乳房重建手术的乳腺癌患者429例,其中术前接受2~8个周期新辅助化疗者236例为新辅助化疗组,直接行乳腺癌切除+假体植入Ⅰ期乳房重建术者193例为单纯手术组。比较2组手术方式、术后引流量、住院时间、术后并发症发生情况以及远期疗效。结果新辅助化疗组101例采用腔镜辅助手术,135例行传统开放手术;单纯手术组75例采用腔镜辅助手术,118例行传统开放手术;2组手术方式比较差异无统计学意义(P>0.05)。新辅助化疗组术后引流量[(284.0±79.4)mL]、术后住院时间[(5.6±1.2)d]与单纯手术组[(289.0±76.8)mL、(5.5±1.0)d]比较差异无统计学意义(P>0.05)。2组术后血肿、手术区域感染、乳头乳晕及皮瓣坏死、患侧上肢水肿、包膜挛缩及假体丢失发生率比较差异均无统计学意义(P>0.05)。新辅助化疗组局部复发率(2.12%)、远处转移发生率(7.63%)和病死率(3.39%)与单纯手术组(1.55%、5.70%、2.59%)比较差异均无统计学意义(P>0.05)。结论新辅助化疗对乳腺癌切除假体植入Ⅰ期乳房重建术后并发症及远期疗效无影响,在获得治疗效果的同时并未对乳房重建带来如伤口愈合不良或皮瓣坏死率增高等不利影响。
Objective To investigate the influences of neoadjuvant chemotherapy(NCT) on postoperative complications and long-term efficacy in patients undergoing immediate reconstruction using prosthesis implantation after breast cancer resection. Methods In 429 breast cancer patients, 236 patients received 2 to 8 cycles of NCT before surgery(NCT group), and 193 patients underwent immediate reconstruction using prosthesis implantation after breast cancer resection(control group). The operation procedure, postoperative drainage volume, length of hospital stay, postoperative complications and long-term efficacy were compared between two groups. Results Endoscopic-assisted surgery was performed in 101 patients in NCT group and 75 patients in control group, while traditional open surgery was performed in 135 patients in NCT group and 118 patients in control group, showing no significant differences between two groups(P>0.05). The postoperative drainage volume((284.0±79.4) mL vs.(289.0±76.8) mL) and the postoperative hospital stay((5.6±1.2) d vs.(5.5±1.0) d) showed no significant differences between NCT group and control group(P>0.05). There were no significant differences in the incidences of hematoma, infection of the surgical area, necrosis of nipple-areola complex and flap,upper extremity edema of the affected side,capsular contracture,and prosthesis loss between two groups(P>0.05).The local recurrence rate(2.12% vs.1.55%),distant metastasis rate(7.63% vs.5.70%)and fatality(3.39%vs.2.59%)showed no significant differences between NCT group and control group(P>0.05).Conclusion Neoadjuvant chemotherapy has no influence on postoperative complications and long-term efficacy in patients undergoing immediate reconstruction using prosthesis implantation after breast cancer resection,neither aggravating poor wound healing and nor increasing necrosis of flap.
作者
钟玲
范林军
杜俊泽
刘静
张婷
陈庆秋
张毅
ZHONG Ling;FAN Linjun;DU Junze;LIU Jing;ZHANG Ting;CHEN Qingqiu;ZHANG Yi(Department of Breast and Thyroid Surgery,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《中华实用诊断与治疗杂志》
2020年第8期782-785,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
西南医院临床创新基金资助项目(SWH2013LC09)。
关键词
乳腺癌
新辅助化疗
假体植入Ⅰ期乳房重建
术后并发症
远期疗效
breast cancer
neoadjuvant chemotherapy
immediate breast reconstruction using prosthesis implantation
postoperative complications
long-term efficacy
