临床外科杂志 ›› 2019, Vol. 27 ›› Issue (1): 51-54.doi: 10.3969/j.issn.1005-6483.2019.01.015

• • 上一篇    下一篇

乳房即刻重建术中胸肌筋膜组织瓣覆盖假体的应用分析

  

  1. 武汉大学人民医院乳腺甲状腺外科
  • 出版日期:2019-01-20 发布日期:2019-01-20
  • 通讯作者: 孙圣荣,Email:sun137@sina.com
  • 基金资助:
    国家自然科学基金资助项目(81302314)

Application analysis of implant coverage with pectoral fascia in immediate implant-based breast reconstruction

  1. Department of Breast and Thyroid Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China
  • Online:2019-01-20 Published:2019-01-20

摘要: 目的 探讨乳腺癌乳房切除后即刻假体乳房重建术中采用胸肌筋膜覆盖假体的可行性及安全性。方法 采用胸肌筋膜覆盖假体的方法行即刻乳房重建术的早期乳腺癌病人27例,对病人术后近期和远期并发症、术后外观满意度、局部复发率、远处转移率及死亡率等进行评估。结果 术后随访3~28个月,中位随访13个月。1例病人出现乳头部分缺血坏死,经换药后愈合,其他病人切口均Ⅰ/甲愈合,术后未出现出血、感染等近期并发症。重建乳房无假体外露、假体移位及包膜挛缩等远期并发症,术后外观评价优良率100%(优21例,良6例)。随访期间所有病人无局部复发、远处转移及死亡。结论 对早期乳腺癌病人行乳房切除术后采用胸肌筋膜覆盖假体进行即刻乳房重建术,是一种安全、可行的乳房即刻重建方法。

关键词: 乳房肿瘤, 乳房切除术, 即刻重建, 假体, 筋膜

Abstract: Objective To explore the method of implant coverage with pectoralis major fascia in immediate implant-based breast  reconstruction  and  to evaluate the feasibility and security.Methods 27 patients with early breast cancer underwent immediate implant-based breast reconstruction after mastectomy with the implant covered by a musculofascial layer composed of the pectoralis major muscle and the superficial pectoral fascia.The therapeutic efficiency and safety was evaluated by retrospectively analyzing the clinical data including the short-and long-term complications,cosmetic results,local recurrence,distant metastases and mortality rates.Results Minor and major complications were reported in a period of follow-up ranging from 3~28 months(median,13 months).One patient had partial nipple necrosis postoperatively and was cured,and no other postoperative complications of hematoma,infection was found.During the follow-up period,no exposure of the implant,implant displacement and capsular contracture were observed.The reconstructive outcomes were excellent in 21 cases and good in 6 case,with an excellent and good rate of 100%.No local recurrence or distant metastasis or death occurred in any of the patients.Conclusion The superficial pectoral fascia flaps can be effectively and safely used as an autologous tissue layer to cover implant in immediate breast reconstruction after mastectomy.

Key words: breast neoplasms, mastectomy, immediate reconstruction, implant, fascia

[1] 邓乐章, 周益, 许勇. 髋关节置换术后股骨假体周围骨折危险因素分析[J]. 临床外科杂志, 2019, 27(2): 163-165.
[2] 王华, 张坤, 李飞 . 深筋膜下非接触锁定钢板治疗隐匿感染性股骨再骨折的效果观察[J]. 临床外科杂志, 2018, 26(12): 959-961.
[3] 谢亚龙, 张伟杰, 陈松等. 肾移植术后坏死性筋膜炎二例报道[J]. 临床外科杂志, 2018, 26(12): 907-909.
[4] 郭树军 张春旭 王全晖等. 腹腔镜经腹会阴低位直肠癌柱状切除及阔筋膜盆底重建的应用(附16例报告) [J]. 临床外科杂志, 2013, 21(4): 277-278.
[5] 胡海清 张松 时宏富 王欣 胡克立 金捷. 膝上外侧筋膜蒂皮瓣修复腘窝区皮肤软组织缺损[J]. 临床外科杂志, 2012, 20(5): 363-363.
[6] 张策 成官迅 李国新 钟世镇. 健康男性直肠周围筋膜的CT和MRI影像学观察[J]. 临床外科杂志, 2012, 20(5): 331-331.
[7] 张玉茹 李非. 肛周坏死性筋膜炎的诊治进展[J]. 临床外科杂志, 2012, 20(1): 69-69.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 胡光俊;宋晓阳;陶军. 右美托咪定添加到罗哌卡因中对腰丛坐骨神经阻滞及镇静的影响[J]. 临床外科杂志, 2016, 24(10): 796 .
[2] 刘国辉;陈熹. 髋臼骨折前、后路联合内固定的治疗策略[J]. 临床外科杂志, 2016, 24(5): 343 -0 .
[3] 张文瑛;李晓峰 . 磷酸钠盐口服液和聚乙二醇电解质溶液用于老年患者术前肠道准备的效果比较[J]. 临床外科杂志, 2016, 24(6): 432 .
[4] 寇晓梅 柯永莉 张晨芳等. 应用邻近扩张皮瓣修复T4期局部晚期乳腺癌术中大面积软组织缺损的临床研究[J]. 临床外科杂志, 2016, 24(9): 675 .
[5] 唐锟;隋璐璐;徐刚等. 不同姑息减黄方式对晚期恶性梗阻性黄疸病人免疫功能的影响[J]. 临床外科杂志, 2017, 25(12): 919 .
[6] 宋举贤;陈健;李建伟;等. 腹腔镜肝切除术治疗小肝癌临床分析[J]. 临床外科杂志, 2017, 25(3): 179 .
[7] 王义生. 股骨头坏死的诊断与治疗原则[J]. 临床外科杂志, 2017, 25(8): 571 .
[8] 周立;宋力;沈立云等. 以腓动脉终末支为蒂携带多个穿支血管的小腿外侧皮瓣修复幼儿足踝部大面积软组织缺损[J]. 临床外科杂志, 2017, 25(8): 594 .
[9] 任朋 张烨 陶建新 沈仁辉 王彤. 吲哚菁绿显像对减少腹腔镜结直肠癌根治术后吻合口漏的作用[J]. 临床外科杂志, 2018, 26(10): 754 -756 .
[10] 赵家运 王志刚 潘乐玉. 限制性输血对直肠癌保肛术后并发症影响分析[J]. 临床外科杂志, 2018, 26(10): 763 -766 .