保留乳头乳晕复合体乳腺癌改良根治术后主要并发症的防治

目的探讨保留乳头乳晕复合体（nipple—areola complex，NAC）乳腺癌改良根治术后主要并发症的防治。方法对手术治疗124例NAC乳腺癌改良根治术临床资料行回顾性总结，分析发生并发症的原因，提出预防和处理方法。结果124例术后发生乳头坏死18例（14．52％），皮瓣感染、坏死9例（7．26％），皮下积液7例（5．65％），上肢淋巴水肿5例（4．03％），胸肌挛缩伴同侧上臂运动障碍3例（2．42％），术腔继发性出血2例（1．61％）。结论精细的手术操作能有效降低保留NAC乳腺癌改良根治术并发症的发生率；保留NAC术后出现的并发症进行积极处理能明显改善患者预后。

Prevention and treatment of the complications of nipple-areola complex sparing modified radical mastectomy

Objective To discuss the prevention and treatment of the complications of modified radical mastectomy with nipple-areola complex （NAC） sparing. Methods The clinical data of 124 breast cancer patients who had a NAC sparing modified radical mastectomy from January 1998 to December 2008 were analyzed retrospectively. The causes of complications were evaluated and the proposal of prevention and treatment was put forward. Results Of the 124 patients, 18 had nipple necrosis （ 14. 52% ）, 9 had skin infections and necrosis （7. 26% ）, 7 subcutaneous hydrops （5.65%） , 5 upper extremity lymphedema （4.03%） , 3 chest muscle contracture with ipsilateral upper limb dyskinesia （2.42%）, and 2 operative residual cavity hemorrhage（ 1.61% ）. Conclusion All the post-operative complications listed above could be possibly avoided by more careful operation procedure.