| 摘要: |
| ［摘要］ 目的 观察单孔腔镜保留乳头乳晕的皮下腺体全切术（NSM）联合假体植入乳房重建术治疗乳腺癌的效果。方法 回顾性分析2020年8月至2023年8月南方医科大学第十附属医院（东莞市人民医院）收治的101例乳腺癌患者的临床资料。根据患者接受术式方法不同将其分为观察组（接受单孔腔镜NSM联合假体植入乳房重建术，39例）和对照组（接受传统开放手术联合假体植入乳房重建术，62例）。比较两组围术期指标、血清肿瘤标志物水平、预后情况及乳房美容效果。结果 观察组手术时间、术口长度、住院时间短于对照组，切口数量、术中出血量少于对照组，差异有统计学意义（P<0.05）。两组并发症发生率比较差异无统计学意义（P>0.05）。两组手术前后血清肿瘤标志物水平比较差异均无统计学意义（P>0.05）。截至2024年10月，两组均未出现局部复发。对照组有2例发生远处转移，其中锁骨上淋巴结转移1例，骨转移1例；观察组无远处转移情况发生。两组随访期间均无死亡。观察组Harris量表评分结果为优和良的比例较高，乳房美容效果的总体情况优于对照组，差异有统计学意义（P<0.05）。结论 单孔腔镜NSM联合假体植入乳房重建术创伤小，患者预后及术后美容效果好，值得临床推荐。 |
| 关键词: 乳腺癌 单孔腔镜手术 保留乳头乳晕的皮下腺体全切术 乳房重建术 临床疗效 |
| DOI：10.3969/j.issn.1674-3806.2025.06.15 |
| 分类号:R 737.9 |
| 基金项目:东莞市社会发展科技项目（编号：20231800904642） |
|
| Observation on clinical effectiveness of laparoendoscopic single-site nipple-areola-sparing subcutaneous mastectomy combined with prosthetic implant breast reconstruction in treatment of breast cancer |
|
YE Xian1,2, DENG Runshu1, YUAN Yongxian1, DENG Dingmei1, WEN Runyao1, HE Guangning1
|
|
1.Department of Breast Diseases, the Tenth Affiliated Hospital, Southern Medical University(Dongguan People′s Hospital), Dongguan 523059, China; 2.Jinan University, Guangzhou 510632, China
|
| Abstract: |
| ［Abstract］ Objective To observe the clinical effectiveness of laparoendoscopic single-site nipple-areola-sparing subcutaneous mastectomy(NSM) combined with prosthetic implant breast reconstruction in treatment of breast cancer. Methods The clinical data of 101 patients with breast cancer who were admitted to the Tenth Affiliated Hospital, Southern Medical University(Dongguan People′s Hospital) from August 2020 to August 2023 were retrospectively analyzed. According to different surgical methods received by the patients, they were divided into observation group(receiving laparoendoscopic single-site NSM combined with prosthetic implant breast reconstruction, 39 cases) and control group(receiving traditional open surgery combined with prosthetic implant breast reconstruction, 62 cases). The perioperative indicators, serum tumor marker levels, prognosis and cosmetic outcome of the breast were compared between the two groups. Results The operative duration, surgical incision length and length of stay in hospital in the observation group were shorter than those in the control group, and the number of incisions and intraoperative blood loss in the observation group were less than those in the control group, with statistically significant differences between the two groups(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05). There were no statistically significant differences in the levels of serum tumor markers between the two groups before and after operation(P>0.05). As of October 2024, no local recurrence occurred in both groups. In the control group, 2 patients had distant tumor metastasis, including 1 case of supraclavicular lymph node metastasis and 1 case of bone metastasis. No distant tumor metastasis occurred in the observation group. There were no death patients in both groups during the follow-up period. The proportion of excellent and good Harris Scale scores in the observation group was higher than that in the control group, and the overall situation of cosmetic outcome of the breast in the observation group was better than that in the control group, with statistically significant difference between the two groups(P<0.05). Conclusion Laparoendoscopic single-site NSM combined with prosthetic implant breast reconstruction is minimally invasive, with good prognosis and favorable cosmetic outcome of the breast after operation, and is recommended for clinical use in treatment of breast cancer. |
| Key words: Breast cancer Laparoendoscopic single-site surgery Nipple-areola-sparing subcutaneous mastectomy(NSM) Breast reconstruction Clinical effectiveness |
