Yamamoto H, Fukutomi T, Nanasawa T, Tsuda H, Hirota T
Dept. of Surgical Oncology, Tokyo Medical College.
Gan To Kagaku Ryoho. 1994 Jun;21 Suppl 2:226-32.
Most profound emotional impact for the women with breast carcinoma is experienced as loss of femininity as a result of surgical mutilation. From this point of view, the recommendation for reconstructive surgery provide the amelioration to patient's anxiety. Two hundred women with breast carcinoma including huge nonepithelial malignant and/or benign tumors who adopted the breast reconstruction were treated during a 13-year period in 1982-1994 at NCCH. The breast reconstruction was mainly created by latissmus dorsi musculocutaneous (LDMC) flap in one sitting (modified mastectomy plus simultaneous reconstruction). Thirty patients treated with subcutaneous mastectomy (conserving the nipple-areolar complex) among them, were followed by deepithelialized LDMC flap without implant as the procedure of choice in early carcinoma located in lateral half at a distance of at least 4-5 cm from the areola and in huge benign tumors. Although one patient was dissatisfied with ischemia of LDMC flap, this approach was safe, simple, and possible to produce the patient's satisfaction. There was a positive effect on life style and on sexual, social or work relationships.
对乳腺癌女性而言，最深刻的情感冲击是因手术致残而导致女性特质的丧失。从这一角度来看，乳房重建手术的建议可缓解患者的焦虑情绪。1982年至1994年期间，在北卡罗来纳州癌症中心，对200例患有乳腺癌（包括巨大的非上皮性恶性和/或良性肿瘤）且接受了乳房重建的女性进行了治疗。乳房重建主要通过一次性背阔肌肌皮瓣（LDMC）（改良乳房切除术加同期重建）完成。其中30例接受皮下乳房切除术（保留乳头乳晕复合体）的患者，对于位于乳晕外侧至少4 - 5厘米处的早期癌以及巨大良性肿瘤，采用去上皮化的LDMC瓣且不植入假体作为首选手术方式。尽管有1例患者对LDMC瓣缺血情况不满意，但该方法安全、简单，且有可能让患者满意。对生活方式以及性、社交或工作关系有积极影响。
