中国修复重建外科杂志

中国修复重建外科杂志

健侧乳房对称成形术在乳腺癌术后假体重建中的应用

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目的 报告一种健侧乳房对称成形术,以解决乳腺癌术后即刻假体重建时双侧乳房不对称的问题。 方法 2016 年 1 月—2018 年 6 月,收治 11 例乳腺癌女性患者。年龄 34~64 岁,平均 49.6 岁。左侧 5 例,右侧 6 例。病理诊断:浸润性癌 3 例,导管内原位癌 8 例。肿瘤直径 0.2~4.1 cm,平均 2.5 cm。病程 1~15 个月,平均 6 个月。乳房下垂程度根据 Regnault 分度标准:轻度 7 例,中度 4 例。术中患侧行保留乳头乳晕复合体的乳房单纯切除、假体植入重建乳房后,行健侧乳房折叠上提乳头乳晕成形术。 结果 手术时间 144~188 min,平均 158 min;住院时间 6~9 d,平均 7.5 d。术后 1 例患侧切口愈合不良,经对症处理后愈合。其余患者切口均Ⅰ期愈合,无手术相关并发症发生。患者均获随访,随访时间 6~30 个月,平均 16 个月。术后 3 个月专家组对乳房美学对称性评分为 8~10 分,平均 8.9 分;患者对双侧乳房对称性评分为 8~10 分,平均 9.1 分。 结论 乳腺癌术后即刻假体重建后,通过健侧乳房对称成形术可获得较满意的双侧乳房外观及对称性。

Objective To introduce a contralateral mastoplasty in breast reconstruction with implant after breast cancer surgery in order to gain bilateral breast symmetry. Methods Between January 2016 and June 2018, 11 female patients with breast cancer were treated, aged 34-64 years old (mean, 49.6 years). There were 5 cases in left side and 6 cases in right side. There were 3 cases of invasive carcinoma and 8 cases of intraductal carcinoma. The diameter of tumor was 0.2-4.1 cm (mean, 2.5 cm). The disease duration ranged from 1 to 15 months (mean, 6 months). According to Regnault grading criteria, there were 7 cases of mild breast ptosis and 4 cases of moderate breast ptosis. Simple nipple-sparing mastectomy and reconstruction using prosthesis of the affected side, and folding and lifting of the nipple-areolar complex of the healthy side were performed. Results The operation time was 144-188 minutes (mean, 158 minutes). The hospital stay was 6-9 days (mean, 7.5 days). Postoperatively, poor wound healing occurred in 1 case and healed after symptomatic treatment. The other incisions healed well and no surgical-related complications occurred. All patients were followed up 6-30 months (mean, 16 months). At 3 months after operation, the expert group adopted the self-made rating scale to evaluate the bilateral breast symmetry, and the score was 8-10 (mean, 8.9). The patients were evaluated for their satisfaction according to the self-made score scale, and the score was 8-10 (mean, 9.1). Conclusion After immediate breat reconstruction with implant after breast cancer surgery, the satisfied bilateral breast appearance and symmetry can be obtained by contralateral mastoplasty.

关键词: 乳腺癌; 乳房再造; 对称性; 成形术

Key words: Breast cancer; breast reconstruction; symmetry; plasty

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