Ⅰ期假体植入乳房重建在乳腺癌术后的临床应用分析

目的 探究乳腺癌术后Ⅰ期硅胶假体植入乳房重建的方法、重建手术之后的效果和方案的可行性.方法 选取2013年5月到2015年1月于大连医科大学附属大连市中心医院乳腺外科行乳腺癌术后Ⅰ期硅胶假体植入乳房重建术的患者46例,对重建乳房的外形、患者的审美评价和复发情况等进行分析.结果 46例患者中,38例符合保留乳头乳晕复合体的标准,另10例切除乳头乳晕复合体后接受背阔肌肌皮瓣转移术、乳房对称整形术等.所有患者术后乳房外观良好,1例患者乳头血运差略发黑,换药后自行愈合,外形无明显变化;1例发生皮下积液、经穿刺后好转;其余患者均无皮瓣坏死、伤口裂开、假体移位等并发症.46患者行植入乳房重建,客观满意度和主观满意度均为93.47%.结论 Ⅰ期假体植入乳房重建手术操作简单易行,美学效果满意,无严重并发症,术后不影响乳腺癌的辅助治疗和远期疗效,是一种安全、可靠的治疗方法,适宜临床推广.

Clinical application of immediate breast reconstruction with prosthetic implants following breast cancer surgery

Objective To explore the clinical application of immediate breast reconstruction with prosthetic implants following breast cancer surgery,reconstruction effect and feasibility of schema.Methods Forty-six patients were selected from May 2013 to January 2015 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University for immediate breast reconstruction with silica gel prosthesis after breast cancer surgery.Analysis was carried on the shape of reconstructed breast,aesthetic evaluation and recurrence.Results Among 46 cases,38 cases kept nipple areola complex and the other 10 cases accepted the latissimus dorsi myocutaneous flap transfer operation and breast anaplasty symmetrically after removal of nipple areola complex.All patients obtained good postoperative breast appearance,and nipple was black in 1 case because of poor blood supply and it healed after dressing change without obvious change in appearance.One case of subcutaneous effusion was better after piercing.No skin flap necrosis,wounds opened or prosthesis displacement and other complications were reported.Both objective satisfaction and subjective satisfaction was 93.47% in 46 patients with immediate breast reconstruction.Conclusion Immediate breast reconstruction with prosthetic implants is simple with satisfactory aesthetic effect,and no serious complications exit.It does not affect postoperative adjuvant therapy and long-term therapeutic effect.It is a safe and reliable treatment suitable for wide popularization and development.