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目的:探讨腹腔镜辅助下乳腺癌根治联合大网膜填充重建对患者上肢功能保护及美容效果的影响。方法:将2014~2017年来我院接受手术治疗的乳腺癌患者按照手术方式不同分为对照组(乳腺癌保乳切除术)及观察组(乳腺癌保乳切除术+腹腔镜辅助大网膜填充重建),比较两组患者手术情况差异以及手术对患者上肢功能、乳房美容效果、术后并发症及患者满意度的影响。结果:手术情况比较,观察组除了手术用时长于对照组外,术中出血量、术后引流时间及引流量、住院时间均少于对照组;对上肢功能影响的结果显示,观察组与对照组在发生麻木(7.4%vs 33.3%)、浮肿(2.9%vs 20%)、外展障碍(11.8%vs 43.4%)的差异上具有统计学意义;此外,观察组与对照组在美容优良率(94.1%vs 40.0%)、并发症发生率(2.9%vs20.0%)、满意度[(16.3±2.8)分vs(7.6±4.4)分]上差异均具有统计学意义。结论:乳腺癌保乳切除术联合腹腔镜辅助大网膜填充重建较单独乳腺癌保乳切除术具有改善患者术后恢复情况,减少手术对患者上肢功能影响,提高乳房美容优良率及患者满意度的优点。
Objective: To investigate the effect of laparoscopic-assisted radical mastectomy combined with omentum reconstruction on functional protection and aesthetic effect of upper limb in patients. Methods: The patients with breast cancer undergoing surgical treatment in our hospital from 2014 to 2017 were divided into control group (breast conserving surgery) and observation group (breast conserving excision + laparoscopic-assisted omentum filling Reconstruction). The differences of operation conditions between the two groups were compared, and the effects of operation on upper limb function, breast cosmetic effect, postoperative complications and patient satisfaction were compared. Results: Compared with the control group, the operation time was shorter in the observation group than in the control group. The bleeding volume, postoperative drainage time, drainage volume and hospital stay were all less than those in the control group. The results of the upper limb function showed that the observation group and the control group The group had statistically significant differences in numbness (7.4% vs 33.3%), edema (2.9% vs 20%), and abduction disorders (11.8% vs 43.4%). In addition, the differences between the observation group and the control group were statistically significant (94.1% vs 40.0%), complication rate (2.9% vs20.0%), satisfaction [(16.3 ± 2.8) vs (7.6 ± 4.4) points]. CONCLUSION: Breast conservatism combined with laparoscopic-assisted omental filling and rebuilding has the advantages of improving the postoperative recovery, reducing the influence of operation on the upper limb function, improving the excellent rate of breast cosmetology and patient satisfaction The advantages.