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一种用于乳腺癌患者乳房重建的新手术方式:病例报告及文献综述

A new surgical modality for breast reconstruction in patients with breast cancer: a case report and literature review.

作者信息

Liu Jiaqi, He Guijin, Zhang Huihui, Yahya Maya Mazuwin

机构信息

Universiti Sains Malaysia, Kelantan, Malaysia.

Department of Breast and Thyroid Surgery, Zibo Central Hospital, Zibo, China.

出版信息

Gland Surg. 2023 Sep 25;12(9):1318-1325. doi: 10.21037/gs-23-5. Epub 2023 Aug 30.

DOI:10.21037/gs-23-5
PMID:37842525
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10570977/
Abstract

BACKGROUND

Breast preservation can considerably improve the postoperative living quality of breast cancer patients. Through this study, we proposed a novel, safe, and effective surgical modality for breast preservation in patients with early breast cancer.

CASE DESCRIPTION

Herein, we present a case report of a patient with early-stage breast cancer (T1cN0M0), who underwent skin-sparing nipple areola hypodermic gland resection combined with primary breast reconstruction using silicone implants. The patient was administered with general anesthesia, and the implants were inserted using a insufflation-free suspension and hook suspension under the pectoralis major muscle. The patient was followed up on postoperative days 1, 2, 7, 14, 30, 60, and 100 to check for any complications, such as upper limb edema, paresthesia, or flap necrosis. The patient experienced no complications. No obvious surgical scars or axillary surface infections were observed. The patient was satisfied with the surgical outcome, and this treatment approach reduced her treatment costs by approximately USD 2,600.

CONCLUSIONS

The new surgical procedure for breast reconstruction considerably improved the quality of life of the patient; no postoperative complications such as skin flap necrosis, paresthesia, or upper limb edema were experienced by the patient; and the treatment costs were reduced. In addition, this method effectively overcomes the concerns related to axillary space instability and limited operative space, rendering it worthy of promotion in clinical practice.

摘要

背景

保乳手术可显著提高乳腺癌患者术后生活质量。通过本研究,我们提出了一种用于早期乳腺癌患者保乳的新型、安全且有效的手术方式。

病例描述

在此,我们报告一例早期乳腺癌(T1cN0M0)患者的病例,该患者接受了保留乳头乳晕的皮下腺体切除术,并使用硅胶假体进行一期乳房重建。患者接受全身麻醉,通过无充气悬吊和钩状悬吊将假体置于胸大肌下方。术后第1、2、7、14、30、60和100天对患者进行随访,检查是否有任何并发症,如上肢水肿、感觉异常或皮瓣坏死。患者未出现并发症。未观察到明显的手术瘢痕或腋窝表面感染。患者对手术效果满意,且该治疗方法使她的治疗费用降低了约2600美元。

结论

新的乳房重建手术显著提高了患者的生活质量;患者未出现皮瓣坏死、感觉异常或上肢水肿等术后并发症;且降低了治疗费用。此外,该方法有效克服了与腋窝空间不稳定和手术空间有限相关的问题,值得在临床实践中推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/66e6b1da1896/gs-12-09-1318-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/272617ac1890/gs-12-09-1318-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/eda79eb96ecd/gs-12-09-1318-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/2ca14f8ffcaf/gs-12-09-1318-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/66e6b1da1896/gs-12-09-1318-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/272617ac1890/gs-12-09-1318-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/eda79eb96ecd/gs-12-09-1318-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/2ca14f8ffcaf/gs-12-09-1318-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/10570977/66e6b1da1896/gs-12-09-1318-f4.jpg

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Analysis of the Role of Continuous Early Intervention in Improving the Quality of Life of Breast Cancer Patients.
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Comput Intell Neurosci. 2022 Jun 16;2022:3054587. doi: 10.1155/2022/3054587. eCollection 2022.
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17-Year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicenter, Randomized Controlled Trial.乳腺癌改良根治术与传统根治术的 17 年随访比较:多中心随机对照研究
Adv Ther. 2022 Jun;39(6):2961-2970. doi: 10.1007/s12325-022-02152-y. Epub 2022 Apr 29.
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Innovative Standards in Oncoplastic Breast Conserving Surgery: From Radical Mastectomy to Extreme Oncoplasty.肿瘤整形保乳手术的创新标准:从根治性乳房切除术到极致肿瘤整形术。
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