乳腺癌改良根治术同期乳房重建的安全性和患者满意度评价

目的观察乳腺癌改良根治术同期行背阔肌肌皮瓣乳房重建的临床效果,评价患者满意度。方法选择病理确诊的乳腺癌患者22例(重建组),行腺癌改良根治术并同期行背阔肌肌皮瓣乳房重建术;匹配同龄、同学历、同TNM肿瘤分期的非乳房重建患者22例作对照(对照组),以Harris标准评价重建乳房的美容效果。随访3年,观察癌组织局部复发转移情况;对患者术后6个月、12个月、24个月和36个月的满意度进行评价。结果两组3年均无肿瘤局部复发及远处转移。乳房重建组优、良、一般分别为14例、5例和3例,患者满意度高于对照组(P0.05),时间因素和分组因素无交互作用(P>0.05)。结论乳腺癌改良根治术同期行背阔肌肌皮瓣乳房重建,不但保证了肿瘤治疗的效果,而且患者的形体美,满意度高。

Safety and Patients Satisfaction in Breast Cancer Patients with Immediate Reconstruction after Radical Mastectomy

Objective To evaluate the therapeutic outcome and patient satisfaction in breast cancer patients with immediate reconstruaction after radical masteetomy. Methods Twenty two patients with breast cancer were treated by immediate reconstruction of latissimus dorsi musculo-cutaneous flap after radical mastectomy （group A）. Twenty two patients with breast cancer were treated by radical mastectomy （group B）. Results According to Harris for cosmetic effect of reconstructive breasts and according to postoperative satisfaction surveyor＇s rod for patient satisfaction. In group A, the results were classified as excellent in 14 cases, good in 5 cases and fair in 3 cases. There were no local recurrence and distal metastasis in both groups. There was significant difference in satisfaction scoring between group A and B （P〈0.05）, but no significant difference in different period after operation （P〉0.05）. Conclusion Radical mastectomy with immediate reconstruction of latissimus dorsi musculo-cutaneons flap has advantages of satisfactory results, cosmetic appearance and patient satisfaction. So it is an ideal and reliable choice for breast reconstruction.