摘要
目的探讨保留皮肤的乳腺癌改良根治术后乳房再造不同术式的疗效对比。方法 2007年1月～2010年12月保留皮肤的乳腺癌改良根治术后乳房再造47例,其中行下腹部横行腹直肌肌皮瓣再造(TRAM)14例,背阔肌肌皮瓣再造(LDM)16例,保留乳头乳晕复合体(NAC)联合假体植入再造17例。结果 3种乳房再造方式在复发率及术后并发症方面均无统计学差异,但术后外观评价方面,LDM组差于其他两组,均由于LDM皮瓣组织量过少或肌萎缩而致双乳不对称。结论 3种乳房再造术式均为乳房再造的常用术式,但保留乳头乳晕复合体(NAC)联合假体植入受病灶距乳头距离的限制,而TRAM适用于乳房较大的乳腺癌患者,LDM适用于乳房不大的乳腺癌患者,行背阔肌肌皮瓣再造乳房时应尽量联合假体植入以达到更好的美容效果。
Objective To explore the effect of different methods of breast reconstruction after skin-sparing mastectomy.Methods From January 2007 to December 2010,the clinical data of 47 cases was reviewed.Among them,14 cases underwent transverse rectus abdominis myocutaneous flap（TRAM）,16 cases underwent latissimus dorsi myocutaneous flap（LDM）,and 17 cases underwent preserving nipple-areolar（NAC） complex and silicone implant.Results No significant differences were found among the 3 groups in terms of the recurrence rate and the postoperative complications.However,the LDM flap procedure seemed to be inferior to the TRAM flap and the preserving NAC and silicone implant according to the cosmetic results（P0.5）.It′s all because LDM flap organization had measured less and the asymmetry of the breasts.Conclusion The 3 methods of breast reconstruction after skin-sparing are the most commonly used surgical procedure for breast reconstruction.But preserving NAC and silicone implant was limited by the distance from the lesion to nipple.TRAM flap was suited for the patients with larger breasts,while LDM flap was suited for the patients with smaller breasts.The latissimus dorsi muscle flap breast reconstruction should be joined with silicone implant as far as possible.Then,the better cosmetic results would be achieved.
出处
《实用临床医药杂志》
CAS
2011年第15期59-61,69,共4页
Journal of Clinical Medicine in Practice
