张敏敏, 莫军扬, 覃舒婷. 乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建与传统改良根治术的疗效比较*[J]. 中国肿瘤临床, 2015, 42(3): 157-161. DOI: 10.3969/j.issn.1000-8179.20141948
引用本文: 张敏敏, 莫军扬, 覃舒婷. 乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建与传统改良根治术的疗效比较*[J]. 中国肿瘤临床, 2015, 42(3): 157-161. DOI: 10.3969/j.issn.1000-8179.20141948
Minmin ZHANG, Junyang MO, Shuting QIN. Comparison of the therapeutic effect between immediate breast reconstruction with latissimus dorsi musculocutaneous flap after modified radical mastectomy and conventional modified radical operation on breast cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(3): 157-161. DOI: 10.3969/j.issn.1000-8179.20141948
Citation: Minmin ZHANG, Junyang MO, Shuting QIN. Comparison of the therapeutic effect between immediate breast reconstruction with latissimus dorsi musculocutaneous flap after modified radical mastectomy and conventional modified radical operation on breast cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(3): 157-161. DOI: 10.3969/j.issn.1000-8179.20141948

乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建与传统改良根治术的疗效比较*

Comparison of the therapeutic effect between immediate breast reconstruction with latissimus dorsi musculocutaneous flap after modified radical mastectomy and conventional modified radical operation on breast cancer

  • 摘要: 目的:比较乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建和传统改良根治术的治疗效果。方法:回顾性分析柳州市人民医院乳腺外科2009年11月至2012年7 月手术治疗0~ⅢA 期女性乳腺癌患者224 例的病例资料,根据手术方式分为乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建(乳房重建)组(n=42)和单纯乳腺癌改良根治术(单纯改良根治)组(n=182),通过对两组患者术后并发症、恢复情况、术后生活质量、局部复发率、远处转移率、病死率进行对比分析,评价两种手术的疗效。结果:两组患者术后积液、皮瓣坏死、患肢及肩关节活动、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),但乳房重建组术后生存质量明显优于单纯改良根治组(P<0.01)。 乳房重建组患者重建乳房外形美学评价明显优于单纯改良根治组(P<0.01)。 随访期间两组转移率、复发率、死亡率的差异均无统计学意义(P>0.05)。 结论:乳腺癌改良根治术后即刻背阔肌皮瓣乳房重建可以达到和传统改良根治术相当的疗效,且其重建乳房外形良好,手术操作简单易行、安全性高,并可显著改善患者术后乳房的外形美观及提高术后生活质量,对早期乳腺癌是一种安全、可行的治疗方法,值得临床推广。

     

    Abstract: Objective:To compare the therapeutic effect of immediate breast reconstruction using latissimus dorsi musculocutane -ous flap after modified radical mastectomy with the conventional modified radical surgery of breast cancer.Methods:A retrospec-tive analysis of 224 female patients with Stage 0 to IIIA breast cancer was conducted. The patients were admitted to the Department of Breast Surgery of Liuzhou People's Hospital between November 2009and July 2012. The cases were divided into two groups accord -ing to different surgical options: immediate breast reconstruction (IBR) and modified radical surgery of the breast (MRSB). After contrastive analyses of the postoperative complications, cosmetic results, quality of life, local failure rate, distant metastases and mortality rates between the two groups, the therapeutic efficiency of the two surgeries was evaluated. Results: No statistical differences were ob-served in the postoperative complications between the two groups, such as hydrops, skin flap necrosis, limb exercise and shoulder joint motion, drainage time, and starting time of adjuvant therapy (P>0.05). The patients in the IBR group had a better quality of life than those in the MRSB group (P<0.01). The aesthetic evaluation of the breast reconstruction was favorable in 39cases and secondary in 3 cases, which surpass the evaluation of the patients in the simple MRSB group. No obvious statistical differences were observed in the distant metastasis rate, local recurrence rate, and mortality rate between the two groups ( P>0.05). Conclusion:Compared with the tradi -tional MRSB group, the option of IBR after modified radical mastectomy not only achieves similar therapeutic outcomes but also pres -ents advantages such as better aesthetic effect of the reconstructed breast, easy surgical procedures, high safety, improvement of the breast contour outline, and improved quality of life after operation. Therefore, IBR is a safe and available therapeutic method for pa-tients with early breast cancer.

     

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