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单孔充气式内镜保乳乳房切除术同期假体植入即刻乳房重建的临床应用

[Clinical application of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation].

作者信息

Gao G X, Wang Z H, Liu W H, Xie F, Xu W, Gang T R, Wu S S, Qu X

机构信息

Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

Department of Surgery, Huairou Maternal and Child Health Care Hospital, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 101400, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2021 Feb 1;59(2):121-126. doi: 10.3760/cma.j.cn112139-20200916-00707.

Abstract

To examine the clinical application value of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer. From February 2014 to July 2019, the clinic-pathological data of 34 early breast cancer patients received single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation at Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. All the patients were female, with an age of 46(11) years (()) (range: 26 to 64 years). The radical cure degree of operation, cosmetic effect after operation were evaluated. The satisfaction to operation and personal quality of life after operation was accessed by BREAST-Q scale. All surgical procedures were successfully completed. The operation time was (313.4±11.7) minutes (range: 200 to 485 minutes). The blooding-liquid was (33.8±3.3) ml (range: 10 to 100 ml). There were 5 cases (14.7%) of nipple areola necrosis after operation, of which 1 patient received taking the prosthesis out because of prosthesis exposure. There was no capsular contracture or postoperative bleeding case. The follow-up time was 35(17) months (range: 12 to 77 months), and there was one case suffering local recurrence and metastasis, and another suffering metastasis. The scores of postoperative breast satisfaction, psychosocial status, chest wall status and sexual health were 78.32±2.57 (range: 55 to 100), 89.12±2.30 (range: 82 to 100), 91.47±1.33 (range: 43 to 100), and 78.50±2.68 (range: 39 to 100). Single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer can achieve provided curative and cosmetic effect on patients with breast cancer, with good patients' postoperative quality of life and satisfaction.

摘要

探讨单孔充气式内镜保乳术联合假体植入即刻乳房重建术在早期乳腺癌治疗中的临床应用价值。回顾性分析2014年2月至2019年7月首都医科大学附属北京友谊医院普通外科收治的34例行单孔充气式内镜保乳术联合假体植入即刻乳房重建术的早期乳腺癌患者的临床病理资料并进行随访。所有患者均为女性,年龄46(11)岁(())(范围:26至64岁)。评估手术根治程度、术后美容效果。采用BREAST-Q量表评估患者对手术的满意度及术后个人生活质量。所有手术均顺利完成。手术时间为(313.4±11.7)分钟(范围:200至485分钟)。出血量为(33.8±3.3)ml(范围:10至100 ml)。术后发生乳头乳晕坏死5例(14.7%),其中1例因假体外露取出假体。无包膜挛缩及术后出血病例。随访时间35(17)个月(范围:12至77个月),发生局部复发转移1例,远处转移1例。术后乳房满意度、心理状态、胸壁状态及性健康评分分别为78.32±2.57(范围:55至100)、89.12±2.30(范围:82至100)、91.47±1.33(范围:43至100)、78.50±2.68(范围:39至100)。单孔充气式内镜保乳术联合假体植入即刻乳房重建术治疗早期乳腺癌能为患者提供较好的疗效和美容效果,患者术后生活质量及满意度良好。

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