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[前锯肌肌瓣联合乳房假体在改良根治性乳房切除术后乳房重建中的应用]

[Application of serratus anterior muscle flap combined with breast implants for breast reconstruction after modified radical mastectomy].

作者信息

Chai Lijun, Zhang Xuehui

机构信息

Department of Breast, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, 450014, P.R.China.

Department of Breast Reconstruction, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1098-1101. doi: 10.7507/1002-1892.201704032.

Abstract

OBJECTIVE

To investigate effectiveness of the combination of serratus anterior muscle flap and breast implants for breast reconstruction after modified radical mastectomy.

METHODS

Between January 2015 and December 2015, 25 female patients with breast cancer were enrolled, aged 24-62 years (mean, 40.6 years). The tumor located at left side in 9 cases and right side in 16 cases; 14 cases were in the left upper quadrant, 4 cases were in the left lower quadrant, 7 cases were on the top of the breast. All cases were invasive ductal carcinoma. According to TNM staging, 14 cases were at stageⅠand 11 cases were at stageⅡA. The diameter of lumps were all less than 3 cm. All those lumps were solitary and without distant metastasis. The sentinel nodes were all negative. After modified radical mastectomy, the breasts were reconstructed by serratus anterior muscle flap and breast implants. The nipples were spared in 22 cases.

RESULTS

The operation time was 113-148 minutes (mean, 136 minutes). All breasts survived and incisions healed at stageⅠ. There was no complication such as hematoma, infection, . All patients were followed up 6-18 months (mean, 15 months). Except 1 case, the others were evaluated according to the criteria of the reconstructed breast at 12 months after operation. Among them, 23 cases were evaluated as good and 1 case as fair. There was no tumor recurrence during the follow-up period.

CONCLUSION

The combination of serratus anterior muscle flap and breast implants after the modified radical mastectomy is a handy approach of breast reconstruction which is less harmful with few postoperative complications. It also gains a high degree of satisfaction from patients for good breast shape.

摘要

目的

探讨前锯肌肌瓣联合乳房假体在改良根治性乳房切除术后乳房重建中的有效性。

方法

2015年1月至2015年12月,纳入25例乳腺癌女性患者,年龄24 - 62岁(平均40.6岁)。肿瘤位于左侧9例,右侧16例;左上肢象限14例,左下肢象限4例,乳房顶部7例。所有病例均为浸润性导管癌。根据TNM分期,Ⅰ期14例,ⅡA期11例。肿块直径均小于3 cm。所有肿块均为单发且无远处转移。前哨淋巴结均为阴性。改良根治性乳房切除术后,采用前锯肌肌瓣联合乳房假体进行乳房重建。22例保留乳头。

结果

手术时间为113 - 148分钟(平均136分钟)。所有乳房均存活,切口Ⅰ期愈合。无血肿、感染等并发症。所有患者随访6 - 18个月(平均15个月)。除1例患者外,其余患者均在术后12个月根据乳房重建标准进行评估。其中,23例评估为良好,1例评估为一般。随访期间无肿瘤复发。

结论

改良根治性乳房切除术后采用前锯肌肌瓣联合乳房假体是一种简便的乳房重建方法,创伤小,术后并发症少,乳房外形良好,患者满意度高。

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本文引用的文献

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Global cancer statistics, 2012.全球癌症统计数据,2012 年。
CA Cancer J Clin. 2015 Mar;65(2):87-108. doi: 10.3322/caac.21262. Epub 2015 Feb 4.

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