切换至 "中华医学电子期刊资源库"

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]. 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]. 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
穆兰花,辛敏强,栾杰.乳腺癌术后乳房重建的研究现状及其评价[J/CD].中华乳腺病杂志:电子版, 2011, 5(2): 215-221.
2
Roostaeian J,Crisera C. Current options in breast reconstruction with or without radiotherapy[J]. Curr Opin Obstet Gynecol, 2011, 23(1): 44-50.
3
Cense HA,Rutgers EJ,LoPes Cardozo M, et al. Nipple-sparing mastectomy in breast cancer: a viable option?[J]. Eur J Surg On-col, 2001, 27(6): 521-526.
4
韩明玥,于伟杰,邱晓冬,等.腹部横行小切口游离带蒂大网膜在一期乳房成形中的应用[J/CD].中华乳腺病杂志:电子版, 2012, 6(6): 649-656.
5
Cheung KL,Blamey RW,Robertson JF, et al. Subcutaneous mas-tectomy for primary breast cancer and ductal carcinoma in situ[J]. Euro J Surg Oncol, 1997, 23(4): 343-347.
6
Medina-Franco MD,Vasconez LO,Fix RJ, et al. Factors associat-ed with local recurrence after skin-sparing mastectomy and im-mediate breast reconstruction for invasive breast cancer[J]. Ann Surg, 2002, 235(6): 814-819.
7
Wright JL,Cordeiro PG,Ben-Porat L, et al. Mastectomy with im-mediate expander-implant reconstruction, adjuvant chemothera-py, and radiation for stage Ⅱ-Ⅲ breast cancer: treatment inter-vals and clinical outcomes[J]. Int J Radiat Oncol Biol Phys, 2008, 70(1): 43-50.
8
Kiricuta I. The use of the great omentum in the surgery of breast cancer[J]. Presse Med, 1963, 71(1): 15-17.
9
Zaha H,Sunagawa H,Kawakami K, et al. Partial breast recon-struction for an inferomedial breast carcinoma using an omental flap[J]. World J Surg, 2010, 34(8): 1782-1787.
10
Zaha H,Inamine S. Laparoscopically harvested omental flap: re-sults for 96 patients[J]. Surg Endosc, 2010, 24(1): 103-107.
11
张道坤,吴溯帆.乳腺癌术后Ⅰ期假体置入乳房重建的研究进展[J].中华医学美容杂志, 2012, 18(1): 78-80.
12
Hamdi M,Craggs B,Stoel AM, et al. Superior epigastric artery perforator flap: anatomy, clinical applications, and review of liter-ature[J]. J Reconstr Microsurg, 2014, 30(7): 475-482.
13
Gill K,Mann R,Brunsworth L, et al. Aesthetic subunit of the breast: an analysis of women's preference and clinical implica-tions[J]. Ann Plast Surg, 2014, 73(2): 249.
[1] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 844-848.
[2] 唐玮, 何融泉, 黄素宁. 深度学习在乳腺癌影像诊疗和预后预测中的应用[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 323-328.
[3] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[4] 衣晓丽, 胡沙沙, 张彦. HER-2低表达对乳腺癌新辅助治疗疗效及预后的影响[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 340-346.
[5] 施杰, 李云涛, 高海燕. 腋窝淋巴结阳性Luminal A型乳腺癌患者新辅助与辅助化疗的预后及影响因素分析[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 353-361.
[6] 伍秋苑, 陈佩贤, 邓裕华, 何添成, 周丹. 肠道微生物在乳腺癌中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 362-365.
[7] 谭巧, 苏小涵, 侯令密, 黎君彦, 邓世山. 乳腺髓样癌的诊治进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 366-368.
[8] 周婉丽, 钱铮, 李喆. 槐耳在乳腺癌免疫治疗中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 369-371.
[9] 熊倩, 罗凤. 乳腺癌患者术后康复现状与对策的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 372-374.
[10] 杨小菁, 姜瑞瑞, 石玉香, 王静静, 李长天. 乳腺孤立性纤维性肿瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 375-377.
[11] 冯雪园, 韩萌萌, 马宁. 乳腺原发上皮样血管内皮瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 378-380.
[12] 康一坤, 袁芃. 三阴性乳腺癌分子遗传学及临床特征研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 290-293.
[13] 王雪菲, 海琳悦, 李立方, 肖春花. Luminal A型乳腺癌的内分泌治疗与化疗[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 294-300.
[14] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[15] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
阅读次数
全文


摘要