文章摘要

采用组织瓣修复腺体残腔在治疗早期乳腺癌及肿瘤整形中的疗效

作者: 1张清, 1区基文, 1马德奎, 1温铭泉
1 肇庆市第一人民医院普外科,广东 肇庆 526000
通讯: 张清 Email: 264355385@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.12.020
基金: 肇庆市科技创新计划(2014E125)。

摘要

目的:探讨肿瘤整形中采用组织瓣修复腺体残腔治疗早期乳腺癌的临床疗效和安全性。方法:回顾性分析2014年1月至2017年1月于肇庆市第一人民医院接受乳腺癌保乳术的早期乳腺癌患者87例,其中42例接受传统的保留乳房的乳腺癌根治术(对照组),45例接受乳腺癌保乳术联合周围组织瓣修复乳房缺损术(研究组),对比两组乳房美学评分、主观满意度、术后并发症和复发率以及生活质量。结果:治疗3个月后与对照组相比,研究组的乳房对称性、表面平整度、皮肤效果、乳头移动距离和美学总分均明显提高(P<0.05);两组皮肤色泽和手术切口瘢痕差异无统计学意义(P>0.05);研究组术后3个月总满意率为93.33%,明显高于对照组总满意率(76.19%,χ2=5.023,P=0.025);两组并发症发生率差异无统计学意义(χ2=0.213,P=0.644);术后1个月研究组疼痛评分明显低于对照组(P<0.05),生理功能、日常生活、认知功能、情感功能以及社会功能评分明显高于对照组(P<0.05);研究组切除标本重量、最近手术切缘距离以及最远手术切缘距离均大于对照组,差异有统计学意义(P<0.05)。结论:将肿瘤整形技术融入至保乳术中,采用腺体组织瓣转位法和背阔肌肌瓣对保乳术后腺体残腔进行修复,不仅能在最大程度上保证切缘阴性,还能保证乳腺完整性和美观性,明显降低手术对患者心灵上的创伤,提高患者的生活质量,值得在临床推广应用。
关键词: 肿瘤整形;乳腺癌;安全性;疗效;美学

Efficacy of tissue flap for repairing residual cavity in the treatment of early breast cancer and oncoplastic surgery

Authors: 1ZHANG Qing, 1OU Jiwen, 1MA Dekui, 1WEN Mingquan
1 Department of General Surgery, First People’s Hospital of Zhaoqing, Zhaoqing Guangdong 526000, China

CorrespondingAuthor: ZHANG Qing Email: 264355385@qq.com

DOI: 10.3978/j.issn.2095-6959.2019.12.020

Foundation: This work was supported by Zhaoqing Science and Technology Innovation Program, Guangdong Province

Abstract

Objective: To investigate the clinical efficacy and safety of tissue flap for repairing residual cavity for early breast cancer in oncoplastic. Methods: We retrospective analyzed of 87 cases of early breast cancer patients who received breast conserving surgery from January 2014 to January 2017 in First People’s Hospital of Zhaoqing, including 42 patients who underwent conventional breast cancer radical prostatectomy (control group), 45 patients with breast cancer confirmed breast augmentation in combination with the surrounding tissue flap to repair defects of breast surgery (research group). The breast aesthetic score, subjective satisfaction, postoperative complications and the recurrence rate and quality of life were compared. Results: At postoperation 3 months, compared with the control group, the surface roughness, skin effects iofn breast, nipple moving distance, aesthetic aspects and the total score of the research group were significantly improved (P<0.05); the skin colour and lustre and incision scar had no statistical significance between the two groups (P>0.05); the postoperative total satisfaction rate of the research group was 93.33%, which was significantly higher than that of the control group (76.19%, χ2=5.023, P=0.025). The incidence of complications in the two groups had no statistically significant (χ2=0.213, P=0.644). One month after surgery, the pain score of the research group was significantly lower than that of the control group (P<0.05), and the scores of physiological function, daily life, cognitive function, emotional function and social function were significantly higher than those of the control group (P<0.05). The weight of resected specimens, the distance of the nearest surgical margin and the distance of the farthest surgical margin in the study group were all larger than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: The tumor plastic technology was integrated into breast conserving surgery, and the gland tissue flap transposition method and latissimus dorsi muscle flap were adopted to repair the gland residual cavity after breast conserving surgery, which could not only ensure negative margin to the greatest extent, but also ensure the integrity and beauty of breast, obviously reduce the trauma to the patient’s mind, improve the patient’s quality of life, and was worthy of clinical popularization and application.
Keywords: oncoplastic; breast cancer; security; curative effect; aesthetic