保留皮肤的乳房切除术即刻重建及微小皮瓣保乳重建对肿瘤整形乳房手术结局的影响

Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery.

作者信息

Gendy R K, Able J A, Rainsbury R M

机构信息

Breast Unit, Royal Hampshire County Hospital, Winchester S022 5DG, UK.

出版信息

Br J Surg. 2003 Apr;90(4):433-9. doi: 10.1002/bjs.4060.

DOI:10.1002/bjs.4060

PMID:12673744

Abstract

BACKGROUND

The aim of this study was to compare the outcomes of skin-sparing mastectomy (SSM) with immediate myocutaneous flap reconstruction and partial mastectomy with latissimus dorsi miniflap reconstruction (LDMF) for breast cancer.

METHODS

Some 106 disease-free patients (57 SSM, 49 LDMF) who had breast reconstruction between 1991 and 1999 participated in this retrospective review. The mean duration of follow-up was 42 (range 6-102) months. Measured outcomes included surgical complications, functional disability, cosmetic result and psychological morbidity.

RESULTS

SSM outcomes were less favourable than LDMF outcomes with regard to postoperative complications (14 versus 8 per cent), further surgical interventions (79 versus 12 per cent), nipple sensory loss (98 versus 2 per cent), restricted activities (73 versus 54 per cent) and cosmetic outcome by panel assessment. Anxiety about residual cancer and ease of breast self-examination were similar in both groups.

CONCLUSION

LDMF was associated with fewer adverse surgical and physical sequelae than SSM, without compromising local control or cosmetic outcome. Both operations were associated with low psychological morbidity.

摘要