本文選題：乳腺癌 + 保乳術(shù)�。� 參考：《廣東醫(yī)學(xué)》2017年12期

【摘要】：目的探討應(yīng)用多方位腺體瓣一期修復(fù)乳腺癌保乳術(shù)后乳房缺損的可行性及美容效果。方法對29例乳腺癌患者,先按常規(guī)方法實施保乳術(shù),接著利用原乳腺切口形成多方位腺體瓣。將周圍缺損的腺體從胸大肌表面分離,再于腺體斷面淺層作水平剖開,形成多個不同方位的腺體瓣,包括兩側(cè)的腺體瓣及中央的腺體瓣。根據(jù)周圍缺損的腺體條件不同,形成腺體瓣長寬可不同,然后將腺體瓣向瘤床滑行推進,盡可能使其無張力對合或疊加,并縫合固定。術(shù)后給予化療、放療和內(nèi)分泌治療等綜合治療。結(jié)果 29例實施保乳的乳腺癌患者,術(shù)后恢復(fù)良好,美容評定達到優(yōu)良乳房美容效果者為23例(79.3%),一般者為6例(20.7%),無美容效果差的患者。隨訪3~48個月,無復(fù)發(fā)轉(zhuǎn)移,外形變化不明顯,患者滿意。結(jié)論應(yīng)用多方位腺體瓣一期修復(fù)乳腺癌保乳術(shù)后乳房缺損,美容效果滿意,具有簡單易行、不增加額外瘢痕、并發(fā)癥少,可耐受放療等優(yōu)點,但不適合于小乳房或低密度腺體類型的患者。
[Abstract]:Objective to investigate the feasibility and cosmetic effect of multi-directional glandular flap for breast defect after breast conserving operation. Methods 29 patients with breast cancer were treated with conserving breast according to the routine method, and then multidirectional glandular flap was formed by the original mammary incision. The surrounding glands were separated from the surface of the pectoralis major muscle and then opened horizontally in the superficial layer of the gland section to form a number of glandular valves in different directions including both sides of the glandular flap and the central glandular flap. According to the different glandular conditions around the defect, the length and width of the glandular flap may be different, and then the glandular flap will glide to the tumour bed, making it as tensionless as possible, involute or superposed, and sutured and fixed. Postoperative chemotherapy, radiotherapy and endocrine therapy and other comprehensive treatment. Results 29 cases of breast cancer with breast conserving were recovered well after operation. 23 cases with excellent breast beauty effect were assessed as good breast beauty, 6 cases with normal breast conserving mammary cancer, and 6 cases with normal breast cancer. There were no patients with poor cosmetic effect. Follow-up for 3 ~ 48 months showed no recurrence and metastasis. Conclusion the application of multi-directional glandular flap in the primary repair of breast defect after breast conserving surgery is satisfactory, simple and easy to carry out, no extra scar, less complications, and can withstand radiotherapy. However, it is not suitable for patients with small breasts or low density glands.
【作者單位】： 深圳市婦幼保健院乳腺科;
【分類號】：R737.9

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本文編號：1976722