乳腺癌根治术后行保留乳头乳晕的乳房再造术治疗早期乳腺癌的临床观察

目的总结乳腺癌根治术后行保留乳头乳晕的乳房再造术治疗早期乳腺癌的临床经验方法通过纳入和排除标准筛选出2015年1月~2018年12月72例早期乳腺癌患者,实施乳腺癌根治术后行保留乳头乳晕的乳房再造术.手术切口选择乳房下皱襞,依次行肿瘤切除术、淋巴结清扫术、假体置入术,术后随访1年.结果本组72例患者均顺利完成手术.手术时间(204.25±26.36)min,术中出血量(513.42±66.75)ml,清扫淋巴结个数为14~18个,术后引流量(134.68±28.56)ml,术后引流时间3~5天.术后发生淋巴水肿3例,皮下积液2例,渗血1例,无皮瓣坏死.术后随访1年,67例患者对乳房形态表示满意,不满意者的首要原因为两侧不对称4例,瘢痕明显1例.所有患者均及未见远处转移及复发.结论符合条件的早期乳腺癌患者,行乳腺癌根治术后行保留乳头乳晕的乳房再造术可获得较好的外形效果,且具有较高的安全性.

Clinical observation on the treatment of early breast cancer by breast reconstruction with nipple and areola reserved after radical mastectomy

Objective To summarize the clinical experience of breast reconstruction with nipple and areola sparing in the treatment of early breast cancer after radical mastectomy.Methods 72 patients with early breast cancer from January 2015 to December 2018 were selected according to the inclusion and exclusion criteria.Breast reconstruction with nipple and areola preservation was performed after radical mastectomy.The incision of the operation was inferior breast fold,followed by tumor resection,lymph node dissection and prosthesis implantation,followed up for 1 year.Results All the 72 patients completed the operation successfully.The operation time was(204.25±26.36)min,the intraoperative bleeding volume was(513.42±66.75)ml,the number of lymph nodes was 14-18,the postoperative drainage volume was(134.68±28.56)ml,and the postoperative drainage time was 3-5 days.There were 3 cases of lymphedema,2 cases of subcutaneous hydrops,1 case of bleeding,no necrosis of flap.One year follow-up showed that 67 patients were satisfied with the shape of breast.The main cause of dissatisfaction was bilateral asymmetry in 4 cases and obvious scar in 1 case.No distant metastasis or recurrence was found in all patients.Conclusion In the eligible early breast cancer patients,breast reconstruction with nipple and areola sparing after radical mastectomy can obtain better appearance effect and high safety.