Endoscopic axillary lymphadenectomy combined with laparoscopically harvested pedicled omentum for immediate breast reconstruction
Endoscopic axillary lymphadenectomy combined with laparoscopically harvested pedicled omentum for immediate breast reconstruction
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DOI：
10.1007/s00464-014-3808-z
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发表时间：
2015-06-01
影响因子：
3.1
通讯作者：
Huang, Zonghai
中科院分区：
文献类型：
--
作者：
Zhang, Pusheng;Luo, Yunfeng;Huang, Zonghai
为探讨内窥镜下腋窝淋巴清扫术(EAL)联合腹腔镜下切取带蒂大网膜(LHPO)立即再造乳房的临床疗效和美容效果，对40例早期乳腺癌患者行EAL、象限切除和LHPO即刻乳房再造。术后6个月按Harris标准评价美容效果，平均手术时间为308min，其中EAL组39min，四肢切除术组63min，LHPO组58min。平均失血量为70ml，主要发生在乳房切除术中。平均而言，患者在手术后9.5天出院。移植物部分坏死和大网膜脂肪液化各1例。术后无其他并发症发生。随访期间未见局部复发或远处转移。美容效果基本令人满意。放疗后再造乳房未见缩小。美容效果“优”35例，“良”4例，“可”1例。EAL联合LHPO再造乳房是一种安全可行的手术方法，手术创伤小，术后乳房柔软、整形。
To determine the therapeutic and cosmetic outcomes of patients with breast cancer treated with endoscopic axillary lymphadenectomy (EAL) combined with laparoscopically harvested pedicled omentum (LHPO) for immediate breast reconstruction.Forty patients with early breast cancer underwent EAL, followed by quadrantectomy and LHPO for immediate breast reconstruction. All patients were evaluated for operating time, blood loss, postoperative hospital stay, complications, etc. The cosmetic outcomes were evaluated 6 months after the surgery, according to the Harris criteria.The average operating time was 308 min, including 39 min for EAL, 63 min for quadrantectomy, and 58 min for LHPO. The average blood loss was 70 ml, and was mainly incurred during breast resection. On average, the patients were discharged 9.5 days after the surgery. Partial graft necrosis and omental fat liquefaction occurred in one patient each. No other complications occurred after the surgery. No local recurrence or distant metastasis was found during the follow-up. The cosmetic results were mostly satisfactory. No size reduction of the reconstructed breast occurred after radiation therapy. Esthetic evaluation of the reconstructed breast showed that the cosmetic outcome was "excellent" in 35 patients, "good" in 4 patients, and "fair" in 1 patient.EAL combined with LHPO for breast reconstruction is a viable, safe procedure that causes minimal surgical trauma and results in a soft, shapely breast postoperatively.