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中华普通外科学文献(电子版) ›› 2016, Vol. 10 ›› Issue (06) : 431 -434. doi: 10.3877/cma.j.issn.1674-0793.2016.06.012

所属专题: 经典病例 文献

论著

保留乳头乳晕的乳房全切术后带蒂大网膜联合假体乳房一期重建23例
卢伶俐1, 万能斌1,(), 周征宇1, 邓宏武1, 何英1, 张轶1, 李国鹏1, 何潇1   
  1. 1. 41000 长沙,湖南省肿瘤医院乳腺外二科
  • 收稿日期:2016-07-18 出版日期:2016-12-01
  • 通信作者: 万能斌

Immediate breast reconstruction with pedicled greater omentum and gel prosthesis following nipple and areola complex sparing mastectomy: a report of 23 cases

Lingli Lu1, Nengbin Wan1,(), Zhengyu Zhou1, Hongwu Deng1, Ying He1, Yi Zhang1, Guopeng Li1, Xiao He1   

  1. 1. The Second Department of Breast Surgery, Hunan Cancer Hospital, Changsha 41000, China
  • Received:2016-07-18 Published:2016-12-01
  • Corresponding author: Nengbin Wan
  • About author:
    Corresponding author: Wan Nengbin, Email:
引用本文:

卢伶俐, 万能斌, 周征宇, 邓宏武, 何英, 张轶, 李国鹏, 何潇. 保留乳头乳晕的乳房全切术后带蒂大网膜联合假体乳房一期重建23例[J/OL]. 中华普通外科学文献(电子版), 2016, 10(06): 431-434.

Lingli Lu, Nengbin Wan, Zhengyu Zhou, Hongwu Deng, Ying He, Yi Zhang, Guopeng Li, Xiao He. Immediate breast reconstruction with pedicled greater omentum and gel prosthesis following nipple and areola complex sparing mastectomy: a report of 23 cases[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(06): 431-434.

目的

探讨保留乳头乳晕的乳房全切术后带蒂大网膜联合假体一期乳房重建的可行性和效果。

方法

选择湖南省肿瘤医院乳腺二科2013年8月至2015年9月收治的0、Ⅰ、Ⅱ期乳腺癌患者23例,所有患者按肿瘤切除原则先行保留乳头乳晕的乳房全切术,取上腹部小切口游离带蒂大网膜联合凝胶假体植入胸大小肌之间行乳房一期重建。

结果

23例大网膜组织瓣全部成活,随访3~25个月,无一例假体移位、破裂,重建乳房外观自然、柔软、形态良好,其中2例导管内癌患者因术后预留乳头乳晕部位皮肤较薄出现了乳头缺血,颜色变黑,随访3个月,未见坏死。随访期间未见一例复发。

结论

保留乳头乳晕的改良根治术后带蒂大网膜联合假体一期乳房重建是一种安全可行且美容效果良好的手术方法。

Objective

To discuss the feasibility and effect of immediate breast reconstruction with pedicled greater omentum and gel prosthesis following nipple and areola complex sparing mastectomy.

Methods

From August 2013 to September 2015, after mastectomy with conservation of nipple and areola, twenty-three patients with stage 0, Ⅰ, Ⅱ breast cancer accepted immediate breast reconstruction with pedicled greater omentum and gel prosthesis.

Results

All the pedicled greater omentum was successfully inserted, and no prosthesis migration and rupture occurred 3 to 25 months after operations. The reconstructed breast was good in shape and with soft feeling. Nipple ischemia occurred in two patients with ductal carcinoma in situ, while skin necrosis was not found within 3 months. There was no recurrence of breast cancer during follow-up period.

Conclusion

Immediate breast reconstruction with pedicled greater omentum and gel prosthesis after mastectomy with conservation of nipple and areola is an effective and safe procedure.

图2 假体联合大网膜乳房重建:假体置于胸大肌后方间隙,大网膜置于胸大肌表面及假体周边空隙
图3 A为术前;B为术后3个月与术前相比:乳房形态逼真,质地柔软,手感良好,双侧对称,美容效果满意(同一患者)
1
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