Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
Ironwood Cancer and Research Centers, Scottsdale, AZ, USA.
Ann Surg Oncol. 2018 Oct;25(10):2823-2828. doi: 10.1245/s10434-018-6604-5. Epub 2018 Jul 2.
The demand for oncoplastic breast surgery has increased significantly in recent years. However, these procedures are often not taught in standard training for breast surgeons, and a simple guide for surgeons to start performing basic oncoplastic breast surgery techniques is not available.
The basic concepts of oncoplastic breast surgery and the tools needed prior to starting these types of procedures are discussed, and the procedure, in a stepwise pattern, for the building blocks of oncoplastic techniques is outlined.
The importance of oncoplastics from a quality of life and oncologic standpoint are described. Key concepts are defined and the decision on when it is necessary to consult reconstructive plastic surgery is delineated. The basic necessities for oncoplastic breast surgery, including patient photographs, important intraoperative tools, anatomic knowledge, and patient selection, are discussed. The building block procedures include aesthetic scar placement, parenchymal closure, deepithelialization, and donut therapeutic mastopexy, which are described in detail.
Oncoplastic breast surgery techniques and clinical reasoning build on one another, allowing a surgeon to move from level I to level II oncoplastic procedures. Even the most basic level I breast conservation oncoplastic skills can improve a patient's cosmetic outcome and are easily learned by a general surgeon.
近年来，对肿瘤整形乳房手术的需求显著增加。然而，这些手术通常不在乳房外科医生的标准培训中教授，并且没有为外科医生提供开始执行基本肿瘤整形乳房手术技术的简单指南。
讨论了肿瘤整形乳房手术的基本概念以及开始进行这些类型手术之前所需的工具，并以逐步的方式概述了肿瘤整形技术的构建块的手术过程。
从生活质量和肿瘤学的角度描述了肿瘤整形的重要性。定义了关键概念，并阐述了何时需要咨询重建整形外科的必要性。讨论了肿瘤整形乳房手术的基本必需品，包括患者照片、重要的术中工具、解剖学知识和患者选择。描述了包括美容性瘢痕放置、实质闭合、去表皮化和环形治疗性乳房上提术在内的构建块手术，这些手术都进行了详细的描述。
肿瘤整形乳房手术技术和临床推理是相互关联的，使外科医生能够从一级肿瘤整形手术进展到二级肿瘤整形手术。即使是最基本的一级乳腺癌保乳整形手术技能也可以改善患者的美容效果，并且易于普通外科医生学习。
