Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Ann Surg Oncol. 2013 Oct;20(10):3341-7. doi: 10.1245/s10434-013-3175-3. Epub 2013 Aug 22.
Round block technique is a unique breast resection through periareolar doughnut incision. However, it is more technically challenging and time consuming. We simplified the procedure by exclusion of round block cerclage. The purpose of this study was to introduce our round block technique without cerclage and to evaluate the results of oncological and cosmetic outcomes.
A total of 92 patients with centrally located breast cancer were treated with breast-conserving surgery using round block technique at Samsung Medical Center from July 2009 to May 2012. All patients had a small breast defect with excised breast volume less than 20 % compared to the total breast volume. We minimized the extent of skin removal and used simple interrupted inverted intradermal sutures without cerclage in doughnut closure. Patient's cosmetic satisfaction was assessed by subjective questionnaires at least 6 months after the operation.
The median size of tumors was 1.7 cm (range 0.5-5.0 cm). The average distance of the tumors from the nipple was 2.0 cm (range 0.0-4.0 cm) on sonogram and most of the tumors were located upper breast (82.6 %). The median operative time was 101.5 min (range 55-180), including axillary surgeries. Median follow-up was 12.0 months (range 2-36), and none of patients have developed local recurrence. Up to the longest 3 years of follow-up, favorable cosmetic results have been found in patients treated with round block technique.
Round block without cerclage is technically easy and feasible for centrally located breast tumors with favorable cosmetic results.
环乳晕圆形切除术是一种独特的乳房切除术方法。然而，该手术技术难度大，耗时较长。我们通过排除环乳晕圆形切除术的环扎来简化该手术。本研究旨在介绍我们不使用环扎的环乳晕圆形切除术，并评估其在肿瘤学和美容学方面的结果。
2009 年 7 月至 2012 年 5 月，三星医疗中心对 92 例中央型乳腺癌患者采用环乳晕圆形切除术进行保乳手术。所有患者均切除的乳房组织体积小于乳房总容量的 20%，存在小的乳房缺损。我们尽量减少皮肤切除范围，并在环乳晕切除的环形切口关闭中使用简单的间断式真皮内缝合，而不使用环扎。术后至少 6 个月，通过主观问卷评估患者的美容满意度。
肿瘤的中位大小为 1.7cm（范围 0.5-5.0cm）。超声检查显示肿瘤距乳头的平均距离为 2.0cm（范围 0.0-4.0cm），大多数肿瘤位于乳房上部（82.6%）。中位手术时间为 101.5 分钟（范围 55-180 分钟），包括腋窝手术。中位随访时间为 12.0 个月（范围 2-36 个月），无患者发生局部复发。在最长 3 年的随访中，采用环乳晕圆形切除术治疗的患者获得了良好的美容效果。
对于中央型乳房肿瘤，不使用环扎的环乳晕圆形切除术技术简单可行，且美容效果良好。
