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[经腋窝切口内镜下保留乳头乳房切除术联合即刻乳房重建的有效性]

[Effectiveness of endoscopic nipple-sparing mastectomy combined with immediate breast reconstruction via axillary incision].

作者信息

Huang Zhenqiang, Chen Kai, Zhu Liling, Zeng Jianfeng, Zhou Zhiping, Li Shunrong

机构信息

Department of General Surgery, the Second Affiliated Hospital of Fujian Medical University, Quanzhou Fujian, 362000, P.R.China;Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510120, P.R.China.

Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou Guangdong, 510120, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Nov 15;32(11):1458-1462. doi: 10.7507/1002-1892.201804027.

Abstract

OBJECTIVE

To introduce an surgical technique of endoscopic nipple-sparing mastectomy (NSM) combined with immediate breast reconstruction through simple single-port access that placed in axillary incision.

METHODS

Between January 2017 and February 2018, 15 female patients with breast cancer (stageⅠ in 5 cases and stage Ⅱ in 10 cases) were treated with endoscopic NSM combined with immediate breast reconstruction through simple single-port access that placed in axillary incision. They were 27-45 years old (mean, 37.5 years). The disease duration ranged from 1 to 24 months (mean, 8 months). The tumor located at the left breast in 8 cases and at the right breast in 7 cases. The diameter of tumor ranged from 1.5 to 3.0 cm (mean, 2.6 cm). The distance between tumor and nipple was 1.8-4.0 cm (mean, 2.3 cm).

RESULTS

After operation, the nipple epidermal necrosis occurred in 1 case, and subcutaneous effusion in 1 case. No subcutaneous emphysema or skin flap necrosis occurred. Postoperative pathological examination showed that 1 case was nipple involvement and was treated with nipple resection. All patients were followed up 7-17 months (mean, 11 months). According to the Harris assessment criteria for appearance of reconstructed breast, there were 4 cases of excellent, 10 cases of good, and 1 case of poor. No tumor recurrence or metastasis occurred during follow-up.

CONCLUSION

It is a safe and feasible method of endoscopic NSM combined with immediate breast reconstruction through simple single-port access that placed in axillary incision, and can obtain good cosmetic results. It is a new option to breast reconstruction.

摘要

目的

介绍一种通过腋窝切口单孔入路的内镜下保乳手术(NSM)联合即刻乳房重建的手术技术。

方法

2017年1月至2018年2月,对15例乳腺癌女性患者(Ⅰ期5例,Ⅱ期10例)采用通过腋窝切口单孔入路的内镜下NSM联合即刻乳房重建术进行治疗。患者年龄27 - 45岁(平均37.5岁)。病程1至24个月(平均8个月)。肿瘤位于左侧乳房8例,右侧乳房7例。肿瘤直径1.5至3.0 cm(平均2.6 cm)。肿瘤与乳头距离1.8至4.0 cm(平均2.3 cm)。

结果

术后1例出现乳头表皮坏死,1例出现皮下积液。未发生皮下气肿或皮瓣坏死。术后病理检查显示1例乳头受累,行乳头切除。所有患者随访7至17个月(平均11个月)。根据乳房重建外观的Harris评估标准,优4例,良10例,差1例。随访期间无肿瘤复发或转移。

结论

通过腋窝切口单孔入路的内镜下NSM联合即刻乳房重建是一种安全可行的方法,可获得良好的美容效果。它是乳房重建的一种新选择。

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