共查询到20条相似文献,搜索用时 78 毫秒
1.
乳腺癌根治术后乳房重建能使患者在一定程度上恢复身体外形,减轻心理压力,恢复自信,提高术后生活质量。乳腺癌根治术后乳房重建已为越来越多的患者所接受。本文将从乳房重建的安全,重建手术方式,放疗对乳房重建的影响,时间选择等方面进行综述。 相似文献
2.
放射治疗对乳腺癌术后乳房重建的影响 总被引:1,自引:0,他引:1
放射治疗在乳腺癌术后的治疗中扮演着重要的角色,乳房重建在乳腺癌术后的治疗中也逐渐被患者接受,放射治疗对乳房重建的影响成为放疗科、乳腺外科和整形外科医生共同关注的问题.本文介绍乳腺癌患者乳房重建的技术和时机选择,以及放射治疗对重建乳房美容效果的影响,同时分析乳房重建对放射治疗技术设计的要求以及在不同放射治疗背景下最合适的乳房重建术. 相似文献
3.
目的 探讨乳头乳晕区乳腺癌术后即刻乳房重建的方法及临床应用。方法 回顾性分析天津医科大学肿瘤医院乳腺一科2004年1月至2007年12月共15例乳头乳晕区乳腺癌患者,其中0期乳腺癌3例,Ⅰ期乳腺癌7例,Ⅱ期乳腺癌5例。15例患者中13例行乳头乳晕区圆形切ISI的保乳手术(标本切缘阴性)后即刻背阔肌皮瓣重建术,2例拟行乳头乳晕区圆形切口的保乳手术,因标本切缘阳性,改行仿根治术,术后行即刻背阔肌皮瓣加假体植入乳房重建术。15例患者中即刻乳头乳晕重建术9例,延期乳头乳晕重建术2例,拒绝乳头乳晕重建4例。结果 13例保乳加背阔肌皮瓣重建患者中12例外形满意,满意率为92.31%,1例缝合后中央区内陷,外形不满意,但大小与健侧对称。2例背阔肌皮瓣联合假体重建乳房外形满意。9例即刻重建乳头乳晕7例成活,2例发生重建乳头部分坏死;3例乳头位置略高于健侧。2例延期乳头乳晕重建均成活,且位置对称。15例中6例发生背部皮下积液,1例背部切口裂开。随访10~48个月,中位随访时间25个月,1例患者出现切口局部复发,复发率为7.69%,无远处转移发生。结论 对乳头乳晕中央区乳腺癌进行保乳手术加即刻背阔肌皮瓣重建术可以提高术后乳房外形满意率,且可行即刻乳头乳晕重建术。保乳手术后局部复发率和远处转移率与根治术无差异。 相似文献
4.
5.
6.
背景与目的:乳腺癌手术方式的选择受到诸多因素影响,本研究旨在分析乳腺癌患者选择乳房重建手术的影响因素,重点探讨居住地距离与乳房重建的关系。方法:回顾性分析了1999年1月—2015年12月复旦大学附属肿瘤医院收治的因单侧或双侧0~Ⅱ期乳腺癌行全乳切除术的女性患者临床资料,分析居住地距离与乳房重建比例的关系。结果:非上海患者选择全乳切除术后乳房重建比例高于上海患者(6.1% vs 4.5%,P<0.001)。居住地距离影响乳房重建比例(P=0.035)。单因素分析显示,居住地距离越远,选择乳房重建手术比例越高,而年龄、体质量指数(body mass index,BMI)、TNM分期与乳房重建的选择呈负相关(P均<0.001)。多因素分析显示,年龄增长、BMI增加、TNM分期较晚是拒绝行乳房重建的独立影响因素(P均<0.001),而居住地距离不是乳房重建的独立影响因素(P>0.05),且与具体乳房重建方式无交互作用。年龄与居住地距离呈负相关(P<0.001)。结论:乳腺癌患者的居住地距离与乳房重建比例呈线性相关;年龄、BMI和疾病分期是影响乳房重建的主要因素。 相似文献
7.
双侧乳腺癌同时进行双侧乳腺切除,术后胸部缺损严重,使患者身心遭受双重打击,极大影响其生活质量。随着自体组织移植乳房重建手术的日益成熟和发展,乳腺癌患者要求乳房重建者日渐增多。本科于2004年4月至2007年8月对3例双侧乳腺癌改良根治术后患者采用双蒂下腹部横行腹直肌肌皮瓣(transverse rectus abdominis myocutaneous flap,TRAM)行即刻双侧乳房重建,均获得成功,重建乳房效果满意。现报告如下。 相似文献
8.
乳腺癌的治疗已经从传统的根治术发展到了现今的保乳及乳房重建治疗。假体置入在乳腺癌即刻乳房重建中得到广泛应用,但部分患者术后需行放射治疗,增加了假体包膜挛缩的发生率,同时二期乳房再造患者形成胸壁瘢痕组织,影响假体置入乳房再造效果。软组织扩张器的应用很好地解决了上述问题,作者就软组织扩张器在乳腺癌术后乳房重建中的应用现状进行综述。 相似文献
9.
10.
乳腺癌术后即时扩展型背阔肌肌皮瓣乳房重建27例分析 总被引:2,自引:0,他引:2
目的探讨乳腺癌改良根治术后应用扩展型背阔肌肌皮瓣即时乳房重建的疗效。方法对27例乳腺癌患者施行乳腺癌改良根治术(其中6例行保留皮肤的乳腺癌改良根治术,21例行保留乳头、乳晕的乳腺癌改良根治术),术后即时切取包括背阔肌及其表面的脂肪和岛状皮肤、髂嵴上方脂肪、背阔肌前沿侧胸部脂肪和肩胛区脂肪构成扩展型背阔肌肌皮瓣,转移至胸壁重建乳房。结果27例即时乳房重建全部获得成功。切除乳房的组织量为180-330ml(平均215ml),移植重建乳房的扩展型背阔肌肌皮瓣组织量为210-380ml(平均245ml)。24例术后辅助化疗,5例辅助放射治疗。随访6~24个月(中位随访12个月),所有患者均生存,术后无一例局部复发、转移。美容效果:优17例,良6例,一般3例,差1例。结论乳腺癌患者行保留皮肤或乳头乳晕改良根治术后应用扩展型背阔肌肌皮瓣即时乳房重建形态良好,不影响术后辅助治疗和远期疗效,作为目前乳腺肿瘤治疗的一种有效补充手段,值得临床推广。 相似文献
11.
乳腺癌是女性常见恶性肿瘤之一。乳腺癌改良根治术是目前治疗乳腺癌的主要手术方式。但手术造成的乳房缺失,给患者的心理和生活带来极大的痛苦。目前,本科开展了保留乳头乳晕的改良根治加腔镜辅助下假体植入乳房成形术(即乳腺癌术后乳房再造)。该手术方式对患者机体创伤小,术后效果好;对恢复患者的自信,提高术后生活质量有重要意义。现将护理体会报告如下。 相似文献
12.
乳腺癌术后一期乳房再造 总被引:5,自引:1,他引:5
背景与目的:乳房再造使乳腺癌全乳切除患者重获完整的乳房外形。本文介绍乳腺癌术后应用带蒂背阔肌肌皮瓣联合或不联合假体和带蒂横向腹直肌肌皮瓣(TRAM)行一期乳房再造的经验,并探讨适合中国乳腺癌患者的乳房再造方式。方法:2000年1月-2005年7月,74例乳腺癌患者乳房切除后,应用背阔肌肌皮瓣或带蒂TRAM行一期乳房再造。结果:再造手术均取得成功,背阔肌肌皮瓣再造62例(83.8%),其中联合假体13例、带蒂TRAM再造12例、联合假体1例。经过2~66个月随访,局部区域复发率4.1%。患者满意度高,可接受度96%。而且这两种自体再造方式在是否需要联合假体上没有差别(P=0.440)。结论:乳腺癌术后一期乳房再造能同时满足肿瘤治疗和形体美容的要求,提高患者生活质量,背阔肌肌皮瓣再造对中国女性适用性好,值得推广。 相似文献
13.
AIMS: The oncological, surgical and cosmetic results, patient satisfaction and psychological morbidity of immediate breast reconstruction following mastectomy for breast cancer were evaluated. METHODS: From 1980 to 1994, 79 immediate breast reconstructions were performed in Malm?. From 1985 immediate breast reconstruction was performed in 21% of mastectomies among patients =65 years. The most common indication for immediate reconstruction was extensive DCIS+/-multifocal invasive growth. In 61 cases permanent implants were used and in 18 expanders. The median volume in the permanent implants was 225 ml, compared with 380 ml in cases where expanders were used. RESUTS: Post-operative complications requiring re-operation occurred in 13%. After introduction of the expander technique, no necrosis requiring explanation has occurred. Of the patients receiving radiotherapy, 71% developed capsular contracture (10/14). Four patients developed locoregional recurrence. Three-quarters of the patients had an acceptable to very satisfactory cosmetic result. Eight per cent were judged to have a Baker III-IV contracture. Of the patients, 85% were satisfied with the softness of the reconstructed breast and 76% stated the result to be in accordance with their expectations. CONCLUSIONS: We find immediate breast reconstruction after mastectomy a safe operation with results comparable to those after late reconstruction and without an increased risk of recurrence. Immediate reconstruction with an implant is not recommended in cases where radiotherapy may be necessary. 相似文献
14.
P. Zhang C.-Z. Li C.-T. Wu G.-M. Jiao F. Yan H.-C. Zhu X.-P. Zhang 《European journal of surgical oncology》2017,43(2):285-293
Background
The purpose of this study was to compare patient outcomes between immediate breast reconstruction (IBR) after mastectomy and mastectomy alone.Methods
We conducted a comprehensive literature search of PUBMED, EMBASE, Web of Science, and Cochrane Library. The primary outcomes evaluated in this review were overall survival, disease-free survival and local recurrence. Secondary outcome was the incidence of surgical site infection. All data were analyzed using Review Manager 5.3.Results
Thirty-one studies, involving of 139,894 participants were included in this paper. Pooled data demonstrated that women who had IBR after mastectomy were more likely to experience surgical site infection than those treated with mastectomy alone (risk ratios 1.51, 95% CI: 1.22–1.87; p = 0.0001). There were no significant differences in overall survival (hazard ratios 0.92, 95% CI: 0.80–1.06; p = 0.25) and disease-free survival (hazard ratios 0.96, 95% CI: 0.84–1.10; p = 0.54) between IBR after mastectomy and mastectomy alone. No significant difference was found in local recurrence between two groups (risk ratios 0.92, 95% CI: 0.75–1.13; p = 0.41).Conclusions
Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of breast cancer. Besides, no evidence shows that IBR after mastectomy increases the frequency of local recurrence. 相似文献15.
16.
目的 比较乳腺癌乳房切除术后两种不同即刻再造方法 的并发症和患者的生存情况.方法 选取女性乳腺癌患者128例,根据治疗方法 不同将患者分为带蒂横行腹直肌肌皮瓣组(腹直肌组)和带蒂横行背阔肌肌皮瓣组(背阔肌组),每组各64例.对两组患者的术后并发症发生情况、骨转移、全身多处转移、局部复发及死亡情况进行统计分析.结果 腹直肌组患者的术后并发症发生率和局部复发率均低于背阔肌组(P<0.05);两组患者的骨转移率、全身多处软组织转移率和病死率比较,差异无统计学意义(P>0.05).结论 乳腺癌乳房切除术后带蒂横行腹直肌肌皮瓣即刻乳房重建术较背阔肌临床效果好. 相似文献
17.
Patricia C. Furey Dougald C. Macgillivray Charles L. Castiglione Lisa Allen 《Journal of surgical oncology》1994,55(3):194-197
A retrospective study was done to evaluate the frequency and severity of wound complications in 112 patients with breast cancer who received adjuvant chemotherapy following mastectomy with immediate breast reconstruction. Data on wound complications were available for 120 mastectomies. The rate of complications in 36 mastectomies treated with chemotherapy after mastectomy and immediate reconstruction was compared to that in 84 mastectomies not receiving adjuvant therapy. There were 25 wound complications (20.8%) in the entire group. The rate of wound complications was 27.8% (10 of 36 mastectomies) in the group treated with adjuvant chemotherapy and 17.9% (15 of 84 mastectomies) in the group that did not receive adjuvant therapy (P = 0.13). No patient had a delay in the initiation of adjuvant therapy because of wound complications secondary to immediate reconstruction. Logistic regression analysis found no correlation between age, type of operation, tumor pathology, stage, number of lymph nodes harvested, type of prosthesis or chemotherapy, and wound complications in patients undergoing immediate breast reconstruction after mastectomy. The frequency of wound complications was not increased in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction. The administration of adjuvant chemotherapy does not need to be delayed in patients who have had immediate breast reconstruction following mastectomy for breast cancer. © Wiley-Liss, Inc. 相似文献
18.
19.
Mastectomy is a mutilating but today unavoidable surgical procedure, that could be indicated as primary treatment of breast
cancer, as prophylactic therapy in well selected high-risk patients, and in the management of treatment failure after breast-conserving
therapy.
Breast reconstruction is a sure, safe, well-proved and aesthetically satisfactory alternative without untoward oncological
consequences, that should be offered to all patients subjected to mastectomy, regardless of disease stage or salvage mastectomy
status. It should be offered through a meticulous, honest, timeless and complete discussion, with an open and respectful attitude
toward the final decision of the patients: breast reconstruction is not for every patient. 相似文献
20.
保留皮肤的乳腺癌改良根治术后即刻乳房再造的临床应用 总被引:3,自引:0,他引:3
目的探讨保留皮肤的乳腺癌改良根治术后即刻再造乳房的适应证、方法、效果及可行性。方法2002年1月至2007年11月本院对94例乳腺癌患者行保留乳房皮肤皮下乳腺组织切除加腋窝淋巴结清扫术后,应用下腹部横行腹直肌肌皮瓣(transverse rectus abdominis myocutaneous flap,TRAM)、背阔肌肌皮瓣(latissimus dorsi myocutaneous flap,LDM)联合或不联合假体、单纯乳房假体植入4种方式即刻再造乳房。结果再造手术均取得成功。带蒂TRAM再造47例,LDM再造共42例(其中联合假体28例),单纯乳房假体植入5例。4例出现轻微术后并发症(4.25%)。经过3~67个月随访,局部区域复发率为0,再造乳房形态自然,效果满意,术后外观评价优良率97.87%。结论合理选择病例行保留皮肤或保留乳头乳晕乳腺癌改良根治术后即刻乳房再造是安全可靠的,切口隐蔽并能够保留原有乳房皮肤的感觉,从而获得最佳美容效果,值得广泛推广和应用。 相似文献