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目的:为消除根治手术对乳腺癌患者所致的形体破坏,改善患者的心理、生理状况及生活质量,探讨一种既达到肿瘤根治性切除,又保留乳房美观外形的简便省时、安全可靠的手术术式。方法:选肿瘤≤4cm,距乳头≥3cm,未侵及皮肤及胸肌的乳腺癌患者,经腋后线纵形切口并切除肿瘤表面皮肤,行保留乳头乳晕的改良根治术,术中乳头后乳腺组织断面快速病检为阴性,即刻取部分背阔肌瓣行乳房再造。结果:手术32例,1例因背阔肌瓣坏死失败,31例乳房再造成功,其中优22例(71.0%),良5例(16.1%),差4例(12.9%);仅1例再造失败(背阔肌瓣坏死予以切除)。随访3年以上9例,随访2～3年11例,2年以下12例。除1例腋淋巴结转移17枚患者术后38个月出现骨转移及锁骨下复发外,其余均无瘤生存。结论:本手术切口隐蔽,且保留了乳头乳晕,再造乳房外形美观、逼真,手感良好。手术简便省时,安全可靠,损伤较小。
Objective: To eliminate the radical operation of breast cancer patients caused by physical damage, improve the patient’s psychological, physiological status and quality of life, to both achieve a radical resection of the tumor, while maintaining the appearance of the breast aesthetic simple, time-saving, safe and reliable Surgical procedures. Methods: The patients with breast cancer ≤ 4 cm, ≥ 3 cm from the nipple and no invasion of the skin and pectoral muscle were resected by resection of the axillary line and resected the surface of the tumor. The modified radical mastectomy with preserved nipple areola, Tissue cross-sectional examination was negative, immediately take some latissimus dorsi flap breast reconstruction. RESULTS: Thirty-two cases (31.1%) were successful in surgery, 32 cases (16.1%) were poor, 4 (12.9%) were poor, and only 1 case Reconstruction failed (latissimus dorsi flap to be removed). Follow-up more than 3 years in 9 cases, followed up for 2 to 3 years in 11 cases, 2 years in 12 cases. Except 1 case of axillary lymph node metastasis in 17 patients 38 months after the occurrence of bone metastases and subclavian recurrence, the rest were tumor-free survival. Conclusion: The surgical incision hidden, and retained the nipple areola, rebuilt breast aesthetic appearance, lifelike, feel good. Simple and time-saving operation, safe and reliable, less damage.