内镜辅助下皮下乳房切除假体植入乳房成形术

目的探讨内镜辅助下的乳房皮下切除加一期假体植入乳房成形术及可行性及美容效果.方法西南医院乳腺中心在2004年1-3月为2例良性乳房疾病需要切除乳房的患者进行了内镜辅助下的乳房切除加一期假体植入乳房成形术.结果2例的手术经验结合文献结果表明:内镜辅助下的乳房皮下切除加一期假体植入乳房成形术切口选在腋前线,切口小且较隐蔽;采用牵拉法建立操作空间,直视操作配合电视摄像,钝性分离与电刀或超声刀切割相结合的方法游离乳房皮瓣;完整切除乳房后钝性游离胸大肌后方间隙并在其中植入乳房硅胶假体.术后加压包扎3周以防止假体向上移位.结论内镜辅助下的乳房皮下切除加一期假体植入乳房成形术在技术上安全可行,且有良好的美容效果.

Video-assisted subcutaneous mastectomy and immediate reconstruction

Objective To explore the feasibility and cosmetic results of video-assisted subcutaneous mastectomy and immediate reconstruction. Methods Two patients who suffered from breast diseases and need to excise the breasts received a video-assisted total subcutaneous mastectomy and immediate reconstruction in our center. Results Both patients felt satisfied on the cosmetic result. According to the operative experience of these two patents combined with review, the key point of the operation was summarized as follows. The incisions on the anterior axillary line were small and concealing. External retraction method was used to establish the working space. Video-assisted operation was combined with euthyphoria. Blunt dissection was combined with electrical surgery unit and ultrasound knife to isolate the breast skin flap. After breast glandectomy was completed, silica gel prosthesis was put into the interspace behind ectopectoralis. Pressure dressing for 3 weeks was done to prevent the prosthesis upward displacement. Conclusion The video-assisted subcutaneous mastectomy and immediate reconstruction is a safe and feasible operation method with the better cosmetic result.