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[改良Regnault “B” 技术作为标准II级肿瘤整形保乳手术的评估]

[Evaluation of the modified Regnault “B” technique as a standard level II oncoplastic breast-conserving surgery].

作者信息

Kelemen Péter, Újhelyi Mihály, Pukancsik Dávid, Sávolt Ákos, Kovács Eszter, Zaka Zoltán, Sándor Zsuzsa, Mátrai Zoltán

机构信息

Daganatsebészeti Központ, Emlő-Lágyrész Daganatsebészeti Osztály,Országos Onkológiai Intézet Budapest, Ráth György u. 7-9., 1122.

Radiológiai Diagnosztikai Centrum,Országos Onkológiai Intézet Budapest.

出版信息

Orv Hetil. 2020 Jun;161(24):1002-1011. doi: 10.1556/650.2020.31738.

Abstract

INTRODUCTION AND AIM

This study aimed to describe the modified Regnault "B" oncoplastic technique as a standard volume-displacement level II oncoplastic breast-conserving surgery and the related clinicopathological study.

METHOD

A retrospective, single-centre study was performed between April 2012 and October 2018 involving 215 breast-cancer patients. Patient characteristics and postoperative complications were recorded, and the quality of life was rated by questionnaires. Aesthetic outcomes were evaluated with BCCT.core software and a five-point Likert scale.

RESULTS

The mean patient age was 53 years (range: 29-81 years), with a median follow-up of 47 months (range: 7-85 months). The average surgery time was 47 min (range: 35-85 min) and the pathological average size of the tumours was 33 mm (range: 18-58 mm). Due to positive surgical margins, 13 (6%) completion re-excisions and 3 (1.4%) mastectomies were performed. In total, 16 complications (7.4%) were recorded. The median Likert scale score was 4.2, and the median overall aesthetic outcome assessed by BCCT.core was 1.3 points. According to the quality of life questionnaire, average points of the results demonstrated a high level of patient satisfaction.

CONCLUSION

In medium- to large-breasted patients, the modified Regnault "B" technique is a safe and repeatable level II volume-displacement oncoplastic breast-conservation technique. This technique allows extended removal (20-50% of breast tissue) of T1-T3 tumours from the upper outer quadrant and the border of outer quadrants of the breast with improved aesthetic results. The advantage of this technique is that contralateral symmetrisation is not required, while disadvantage of this technique is the skin incision on the breast skin envelope that can make some difficulties when completion mastectomy is required with immediate reconstruction. Orv Hetil. 2020; 161(24): 1002-1011.

摘要

引言与目的

本研究旨在描述改良的Regnault“B”肿瘤整形技术,将其作为一种标准的容积置换二级肿瘤整形保乳手术及相关临床病理研究。

方法

2012年4月至2018年10月在单中心进行了一项回顾性研究,纳入215例乳腺癌患者。记录患者特征及术后并发症,通过问卷调查对生活质量进行评分。使用BCCT.core软件和五点李克特量表评估美学效果。

结果

患者平均年龄53岁(范围:29 - 81岁),中位随访时间47个月(范围:7 - 85个月)。平均手术时间47分钟(范围:35 - 85分钟),肿瘤病理平均大小33毫米(范围:18 - 58毫米)。因手术切缘阳性,进行了13例(6%)补充再次切除和3例(1.4%)乳房切除术。共记录16例并发症(7.4%)。李克特量表中位评分为4.2分,BCCT.core评估的中位总体美学效果为1.3分。根据生活质量问卷,结果平均分显示患者满意度较高。

结论

在中至大乳房患者中,改良的Regnault“B”技术是一种安全且可重复的二级容积置换肿瘤整形保乳技术。该技术允许从乳房外上象限及外象限边界广泛切除(乳房组织的20% - 50%)T1 - T3肿瘤,美学效果更佳。该技术的优点是无需对侧对称化,缺点是乳房皮肤包膜上的皮肤切口在需要即刻重建的乳房切除术中可能会带来一些困难。《匈牙利医学周报》。2020年;161(24): 1002 - 1011。

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