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目的:观察腹腔镜下游离带蒂大网膜乳房填充术治疗早期乳腺癌的效果。方法:选择行保乳早期乳腺癌33例,根据是否同意行带蒂大网膜乳房成形术分为观察组15例和对照组18例。对照组常规保乳术;观察组在对照组基础上加行腔镜下带蒂大网膜乳房成形术。比较两组手术时间、术中出血量、住院时间、临床效果及不良反应发生情况。结果:观察组手术时间、术中出血量显著长(多)于对照组(P<0.05);两组住院时间比较,差异不显著(P>0.05)。观察组总优良率86.7%,显著高于对照组的50.0%(P<0.05)。观察组术后2周残腔积液发生率非常显著低于对照组(P<0.01),两组术后均未发生皮缘坏死、感染等严重不良反应。随访6~24个月,两组均未发生复发和转移。结论:常规保乳术+腔镜下带蒂大网膜瓣乳房成形术治疗早期乳腺癌效果优于常规保乳术。
Objective: To observe the effect of laparoscopic free pedicled omental breast augmentation in the treatment of early stage breast cancer. Methods: 33 breast-conserving breast cancer patients were selected and divided into observation group (n = 15) and control group (n = 18) according to whether or not consent was given to pedicled omental breast augmentation. The control group received routine breast-conserving surgery. The observation group was treated with endoscopic pedicled omental mastectomy on the basis of the control group. The operation time, intraoperative blood loss, hospitalization time, clinical effect and incidence of adverse reactions were compared between the two groups. Results: The operation time and blood loss in observation group were significantly longer (more) than those in control group (P <0.05). There was no significant difference between the two groups in hospitalization time (P> 0.05). The total good rate of observation group was 86.7%, which was significantly higher than that of the control group (50.0%, P <0.05). The incidence of residual effusion in the observation group 2 weeks after operation was significantly lower than that in the control group (P <0.01). No serious adverse reactions such as skin edge necrosis and infection occurred in both groups. Follow-up 6 to 24 months, no recurrence and metastasis in both groups. Conclusion: Conventional breast-conserving surgery and endoscopic pedicled greater omentum flap surgery is superior to conventional breast-conserving surgery in the treatment of early-stage breast cancer.