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目的探讨早期乳腺癌(II、Ia期)保留乳头乳晕复合体的改良根治术同期应用下腹部横行腹直肌肌皮瓣(TRAM)转移乳房再造的可行性。方法对15例早期乳腺癌患者行保留乳头乳晕复合体改良根治术的同时应用下腹部横行腹直肌肌皮瓣转移乳房再造。结果应用该方法治疗均获成功。仅1例患者出现部分皮瓣血运欠佳。随访10~48个月(平均19个月),再造乳房效果良好,均无癌局部复发或远处转移。结论早期乳腺癌保留乳头乳晕复合体的乳腺癌改良根治术同期应用下腹部横行腹直肌肌皮瓣转移乳房再造安全可行,可同时满足肿瘤治疗和形体美两方面的要求,提高了患者的生活质量。
Objective To investigate the feasibility of modified radical mastectomy for preserving the nipple areola complex in early stage breast cancer (stage II, la) and concurrent transfer of breast reconstruction with traumatic rectus abdominis myocutaneous flap (TRAM) in the lower abdomen. Methods Fifteen patients with early breast cancer underwent modified radical mastectomy with nipple-areola complex and transabdominal transfer of transversal rectus abdominis myocutaneous flap. Results The application of this method were successful. Only one patient showed partial flap poor blood supply. All the patients were followed up for 10 ~ 48 months (average 19 months). The breast reconstruction was effective and no local recurrence or distant metastasis was found. Conclusions Modified radical mastectomy for breast cancer with preserved nipple areola complex in early stage of breast cancer is feasible and safe in the same period with transposition of transversal rectus abdominis musculocutaneous flap in lower abdomen. It can meet the requirements of both cancer treatment and body shape at the same time, and improve the life of patients quality.