非哺乳期乳腺炎乳腺全部切除术后即刻行腹腔镜下带蒂大网膜乳房重建术应用研究

陈晨; 刘先富; 张晓静; 陈延松; 唐经纬; 金功圣

doi:10.13898/j.cnki.issn.1000-2200.2023.08.005

非哺乳期乳腺炎乳腺全部切除术后即刻行腹腔镜下带蒂大网膜乳房重建术应用研究

Study on the application of immediate laparoscopic pedicled greater omental breast reconstruction after total mastectomy for non-puerperal mastitis

摘要

摘要:
目的探讨非哺乳期乳腺炎病人行乳腺全部切除术后即刻腹腔镜下带蒂大网膜乳房重建的临床应用。
方法选取复杂难治型非哺乳期乳腺炎病人52例, 其中35例为观察组, 行乳腺全部切除术后即刻腹腔镜下带蒂大网膜乳房重建术; 17例为对照组, 行乳腺区段切除术后行腺体对拢缝合。观察并记录2组病人手术相关指标及术后6个月的疾病复发率、并发症发生率及美容效果等。
结果观察组手术时间明显长于对照组, 术后引流管留置时间明显短于对照组(P < 0.01)。术后随访6个月, 对照组术后炎症复发3例, 术后复发率为17.65%, 观察组无术后复发病例。2组病人术后美观效果及满意度差异均有统计学意义(P < 0.01)。
结论乳腺全部切除术后即刻腹腔镜下带蒂大网膜乳房重建术在复杂难治疗型非哺乳期乳腺炎乳腺炎治疗中安全可靠、复发率低、美容效果好, 值得推荐。

Abstract:
ObjectiveTo investigate the clinical application value of immediate laparoscopic pedicled greater omental breast reconstruction after total mastectomy for non-puerperal mastitis.
MethodsA total of 52 patients with refractory non-puerperal mastitis were divided into the observation group(35 cases) and control group(17 cases).The observation group was treated with laparoscopic pedicled greater omental breast reconstruction immediately after total mastectomy, and the control group was treated with glandular suture after breast segmentectomy.The postoperative indexes, recurrence rate, complication rate and cosmetic effects were observed and recorded in two groups.
ResultsThe operation time in the observation group was significantly longer than that in control group, and the indwelling time of the postoperative drainage tube in the observation group was significantly shorter than that in control group (P < 0.01).After 6 months of postoperative follow-up, the postoperative inflammation recurred in 3 cases in the control group, and the recurrence rate of which was 17.65%.No case in the observation group recurred after operation.The differences of the ostoperative aesthetic effects and satisfaction were staistically significant between two groups(P < 0.01).
ConclusionsThe immediate laparoscopic pedicled greater omental breast reconstruction after total mastectomy is safe, reliable, has low recurrence rate and good cosmetic effects in the treatment of complex and refractory non-puerperal mastitis, which is worthy of promotion.

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