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乳腺癌保乳手术保持乳头外形的手术技巧探讨(1)
http://www.100md.com 2011年7月5日 刘命文 李理 李双洋 戚春祺
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     [摘要] 目的:总结乳腺癌手术保持乳房良好外形应注意的问题和手术操作技巧。方法:对我院2001年4月~2010年5月89例乳腺癌患者实行了保乳手术。术后从手术瘢痕、乳头外形、两侧乳头水平差距等方面按优、良、差为等级评估保乳手术的美容效果。结果:术后评估乳房外形优良者79例(88.8%),乳房外形较差者10例(11.2%),其中切口瘢痕致乳房畸形(5例),乳头不自然挺立(3例),与对侧乳头水平高度差距明显(1例),乳头歪斜(1例)。结论:目前对保乳手术中乳房外观的重视不够是乳腺外科突出问题,乳腺癌治疗过程中应注意合理选择手术切口、预防乳头歪斜、掌握好乳腺组织切除的量及缝合技巧,以尽量保持乳房的良好的外观。

    [关键词] 乳腺癌;保乳手术;整形

    [中图分类号] R737.9 [文献标识码] B [文章编号] 1673-7210(2011)07(a)-139-02

    Techniques of maintaining breast appearance by conserving surgery in breast cancer patients

    LIU Mingwen, LI Li, LI Shuangyang, QI Chunqi

    The First People's Hospital in Xiangtan City Affiliated to South China University, Hu′nan Provinece, Xiangtan 411101, China

    [Abstract] Objective: To summarize the problems and techniques of maintaining breast appearance by conserving surgery in breast cancer patients. Methods: 89 patients had breast conserving surgery from April 2001 to May 2010 in our hospital. Postoperation breast appearance were evaluated by excellent, good, bad level from surgical scar, mammillary shape, the distance difference of bilateral mamillary to median sternal line, et al. Results: 79 cases patients(88.8%) got the good breast appearance after surgery, the others (10 cases,11.2%) got poor ones, main and frequent problems included breast distortion (5 cases), mammilla unnatural erected (3 case), mammillary deflection (1 case), and significant difference of bilateral mammillary (1 case). Conclusion: Outstanding problems of breast surgery are no enough attention to the appearance of breast in breast conserving surgery now. Breast cancer treatment should pay attention to a reasonable choice of surgical incision, prevention of nipple skew and master the amount of breast tissue excision and suture techniques to maintain the better breast appearance.

    [Key words] Breast cancer; Breast conserving surgery; Plastic

    乳腺癌是女性最常见的恶性肿瘤,随着人们对生活质量的日益重视,保留乳房手术已成为早期乳腺癌的主流手术,而外形良好是乳腺癌保留乳房手术欲实现的最重要目标之一。因此,即使是乳头歪斜、切口瘢痕致乳房变形等轻微并发症也意味着保乳手术的不完美或失败[1]。笔者收集近10年来我科开展的89例保乳手术患者资料,总结保持术后乳腺良好外形的经验及技巧,现报道如下:

    1 资料与方法

    1.1 一般资料

    2001年4月~2010年5月收治的89例乳腺癌行保乳手术治疗的患者,全部为女性,年龄29~56岁 ......

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