中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (04): 444-448.DOI: 10.19538/j.cjps.issn1005-2208.2023.04.17

• 论著 • 上一篇    下一篇

3D成像技术联合胸外侧动脉穿支皮瓣用于乳腺癌保乳整形手术研究

徐元兵a，潘    代b，刘    懿c，康嗣如d，沈浩元a，孙    鑫a，苏婷婷a，胡超华a   

  1. 武汉科技大学附属孝感医院  a.甲状腺乳腺外科 b.超声科 c.妇瘤科 d.磁共振室，湖北孝感 432100
  • 出版日期:2023-04-01 发布日期:2023-04-18

  • Online:2023-04-01 Published:2023-04-18

摘要： 目的    探讨3D成像技术联合胸外侧动脉穿支（LTAP）皮瓣在乳腺癌保乳整形手术中的临床应用价值。方法    回顾性分析 2020 年3月至 2022年9月武汉科技大学附属孝感医院甲状腺乳腺外科收治的应用3D成像技术联合LTAP 皮瓣修复乳房部分缺损的32例乳腺癌病人的临床资料。所有病人术前均进行乳腺3D重建，计算术前患侧乳房体积（UBV）和术前预计切除组织体积（PETV）。保乳整形术后进行组织标本切缘病理学评价及乳房美学评价。结果    所有32例病人均成功完成手术，且术后无明显肿瘤复发。32例病人PETV为（55.1±15.2）mL，PETV/UBV范围为0.20~0.47，AETV为（59.7±17.3）mL，PETV与术中实际切除组织体积（AETV）的差异无统计学意义（P>0.05），两者具有较好的一致性（P<0.01）。所有病人保乳术后切缘均为阴性，术后未发生出血和感染。术后6个月，BREAST-Q量表评分乳房满意度为（82.2±2.4）分，胸壁状态评分为（92.8±2.8）分，社会心理状态评分为（90.5±3.8）分，性健康程度评分为（75.6±7.4）分。结论    在乳腺癌保乳整形手术中利用3D成像技术能较好预测切除组织体积，联合使用LTAP皮瓣填充保乳术后残腔缺损能有效提高手术美容效果。

关键词: 乳腺癌, 保乳, 3D成像, 胸外侧动脉, 皮瓣

Abstract: Application of 3D imaging technology combined with lateral thoracic artery perforator flap in breast-conserving plastic surgery for breast cancer        XU Yuan-bing*，PAN Dai，LIU Yi，et al. *Department of Thyroid and Breast Surgery，Xiaogan Hospital Affiliated to Wuhan University of Science and Technology，Xiaogan 432100，China 
Corresponding author：HU Chao-hua，E-mail：hch_xgzy@126.com
XU Yuan-bing and PAN Dai are the first authors who contributed equally to the article
Abstract    Objective    To investigate the clinical application value of 3D imaging technology combined with lateral thoracic artery perforator flap in breast-conserving plastic surgery for breast cancer. Methods    The clinical data of 32 patients with breast cancer treated with 3D imaging combined with LTAP flap for partial breast defect repair in a single center from March 2020 to September 2022 were retrospectively analyzed. All patients underwent 3D breast reconstruction before surgery, and PETV was calculated before surgery. Histological and aesthetic evaluation of breast were performed after breast conserving plastic surgery. Results    All 32 patients successfully completed the operation，and there was no obvious tumor recurrence after operation. The average PETV of 32 patients was (55.1±15.2) mL, the PETV/UBV range was 0.20-0.47，and the AETV was (59.7±17.3) mL. There was no significant difference between PETV and AETV (P>0.05)，both had a good consistency (P<0.01). Resection margin was negative in all patients after breast-conserving surgery，and no postoperative bleeding or infection. The BREAST-Q scores 6 months after operation showed the postoperative breast satisfactory degree，chest wall status score，psychosocial status score，and sexual health score were 82.2±2.4，92.8±2.8，90.5±3.8，75.6±7.4．Conclusion    3D imaging technology can better predict the volume of resected tissue in breast conserving plastic surgery, and the combination of LTAP flap to fill the residual cavity defect after breast conserving surgery can effectively improve the aesthetic outcome of surgery.

Key words: breast cancer, breast-conserving surgery, 3D imaging, lateral thoracic artery, flap