腔镜辅助保留乳头乳晕复合体联合假体+Ti-Loop补片乳房重建治疗乳腺癌效果评价

Efficacy of endoscopic-assisted nipple-areola complex preservation combined with prosthesis+Ti-Loop patch breast reconstruction in treatment of breast cancer

  • 摘要:
    目的 探讨腔镜下保留乳头乳晕复合体(NAC)的腺体切除术复合假体+Ti-Loop补片乳房重建治疗乳腺癌(BC)的效果及对术后并发症的影响。
    方法 选取行BC根治术患者162例,随机分为对照组和研究组,每组81例。对照组予以腔镜下保留NAC的腺体切除术复合即刻假体乳房重建治疗,研究组予以腔镜下保留NAC的腺体切除术复合假体+Ti-Loop补片乳房重建治疗。比较2组手术时间、术中出血量、术后引流时间、开始新辅助化疗时间、术后首次下床活动时间、术后24 h视觉模拟评分法(VAS)评分、住院时间和手术前后乳房美观度评分、自尊量表(SES)评分、生活质量综合评定问卷(GQOLI-74)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分及术后并发症、复发、转移和生存情况。
    结果 研究组手术时间长于对照组,但术后首次下床活动时间、住院时间短于对照组,术后24 h VAS评分低于对照组,差异有统计学意义(P < 0.05)。术后1周~6个月,研究组BC患者美观度评分高于对照组; 术后6个月,研究组SES评分、GQOLI-74评分均高于对照组, SAS评分、SDS评分均低于对照组; 研究组皮下积液、切口坏死、上肢水肿和乳头坏死发生率低于对照组,差异有统计学意义(P < 0.05)。2组术后随访期间肿瘤局部复发、病死率及远处转移发生率差异无统计学意义(P>0.05)。
    结论 腔镜下保留NAC的腺体切除术复合假体+Ti-Loop补片乳房重建治疗BC手术效果较好,可有效降低术后并发症发生率,安全性好。

     

    Abstract:
    Objective To investigate the efficacy of endoscopic-assisted glandular resection with preservation of the nipple-areola complex (NAC) combined with prosthesis+Ti-Loop patch breast reconstruction in the treatment of breast cancer (BC) and its impacts on postoperative complications.
    Methods A total of 162 patients undergoing radical mastectomy for BC were selected and randomly divided into control group and study group, with 81 cases in each group. The control group received endoscopic-assisted glandular resection combined with preservation of the NAC and immediate prostheticbreast reconstruction, while the study group received endoscopic-assisted glandular resection with preservation of the NAC combined with prosthesis+Ti-Loop patch breast reconstruction. The operative time, intraoperative blood loss, postoperative drainage time, time to initiation of neoadjuvant chemotherapy, time to first postoperative ambulation, 24-hour postoperative Visual Analogue Scale (VAS) score, hospital stay, and preoperative and postoperative breast aesthetic scores, Self-esteem Scale (SES) scores, General Quality of Life Inventory-74 (GQOLI-74) scores, Self-rating Anxiety Scale (SAS) scores, Self-rating Depression Scale (SDS) scores, as well as postoperative complications, recurrence, metastasis, and survival were compared between the two groups.
    Results The operative time in the study group was longer than that in the control group, but the time to first postoperative ambulation and hospital stay were shorter, and the 24-hour postoperative VAS score was lower in the study group, with statistically significant differences(P < 0.05). From 1 week to 6 months postoperatively, the breast aesthetic scores of BC patients in the study group were higher than those in the control group. At 6 months postoperatively, the SES scores and GQOLI-74 scores in the study group were higher than those in the control group, while the SAS scores and SDS scores were lower; the incidences of subcutaneous effusion, incision necrosis, upper limb edema, and nipple necrosis in the study group were lower than those in the control group, with statistically significant differences (P < 0.05). During the postoperative follow-up period, there were no statistically significant differences in the local tumor recurrence rate, mortality rate, and incidence of distant metastasis between the two groups (P>0.05).
    Conclusion Endoscopic-assisted glandular resection with preservation of the NAC combined with prosthesis+Ti-Loop patch breast reconstruction for BC has good surgical efficacy, and can effectively reduce the incidence of postoperative complications, so it is a safe approach.

     

/

返回文章
返回