论文部分内容阅读
目的评价扩大背阔肌肌皮瓣在乳腺癌改良根治术后一期乳房再造中的应用价值。方法选取我科2008年1月至2009年6月期间收治的48例乳腺癌患者,根据所接受的术式分为扩大背阔肌肌皮瓣一期乳房再造(乳房再造)组(n=12)和单纯乳腺癌改良根治术(单纯根治)组(n=36),对2组患者术后并发症、恢复情况以及生活质量进行对比,并对再造乳房外观形态进行评价。结果乳房再造组患者均成功行扩大背阔肌肌皮瓣乳房再造,再造乳房外形评价良好6例,中4例,差2例,明显优于单纯根治组(P<0.001)。2组患者术后积液、皮瓣坏死、患肢及肩关节活动、住院时间、引流时间及开始辅助治疗时间差异均无统计学意义(P>0.05),但乳房再造组术后生活质量较好,与单纯根治组比较差异有统计学意义(P<0.001)。乳房再造组有10例行术后辅助放化疗,未出现转移皮瓣坏死。2组患者随访2～17个月(中位时间8个月),未见局部复发及转移。结论乳腺癌根治术后扩大背阔肌肌皮瓣一期再造乳房形态效果良好,手术操作简单,对早期乳腺癌是一种安全、可行的治疗方法 。
Objective To evaluate the value of expanding the latissimus dorsi myocutaneous flap in primary breast reconstruction after modified radical mastectomy for breast cancer. Methods Forty-eight patients with breast cancer were enrolled in our department from January 2008 to June 2009, and were divided into one group (n = 12) with enlarged latissimus dorsi myocutaneous flap ) And simple radical mastectomy (radical mastectomy) group (n = 36). Comparisons were made between postoperative complications, quality of life and quality of life of the two groups. The appearance of the reformed breast was evaluated. Results All the patients in breast reconstruction group were successful in breast reconstruction with latissimus dorsi myocutaneous flaps. The shapes of breast reconstruction were good in 6 cases, 4 cases in middle and 2 cases in poor condition, which were significantly better than those in radical only group (P <0.001). There was no significant difference in postoperative effusion, flap necrosis, limb and shoulder joint activity, hospital stay, drainage time and the time of starting adjuvant therapy between the two groups (P> 0.05). However, postoperative quality of life of breast reconstruction group Good, compared with simple radical group was statistically significant (P <0.001). Breast reconstruction group had 10 cases of postoperative adjuvant radiotherapy and chemotherapy, there is no transfer of flap necrosis. Two groups were followed up for 2 to 17 months (median 8 months), no local recurrence and metastasis. Conclusions Breast cancer after augmentation latissimus dorsi myocutaneous flap a good shape of breast reconstruction, the operation is simple, is a safe and feasible treatment for early breast cancer.