Abstract:

Timing and surgical management for breast reconstruction after mastectomy        WU Jiong, YANG Ben-long. Department of Breast Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Corresponding author: WU Jiong, E-mail: wujiong1122@vip.sina.com
Abstract    Combined with the concept and technique of plastic surgery, breast reconstruction has become an important development direction in the field of breast surgery on the premise of ensuring tumor safety. Breast reconstruction can be performed at the same time as mastectomy or partial mastectomy, or it can be delayed until the appropriate time after the completion of adjuvant therapy. The former is called immediate breast reconstruction, and the latter is called delayed breast reconstruction. Clinically, the timing of reconstruction is determined by the stage of disease and the patients’ needs. Delayed-immediate breast reconstruction was used in some patients to reduce the adverse effects of adjuvant radiotherapy and the occurrence of serious postoperative complications. Breast reconstruction also includes autologous flap breast reconstruction, implant-based breast reconstruction and autologous combined implant breast reconstruction. Implant based reconstruction is the most commonly used technique in immediate breast reconstruction. For delayed breast reconstruction, autologous flap-based breast reconstruction or two-step implant-based reconstruction is more frequently.

Key words: immediate breast reconstruction, delayed breast reconstruction, delay-immediate breast reconstruction, autologous flap breast reconstruction, implant based breast reconstruction

摘要：

结合整形外科的理念和手段，在保证肿瘤安全性的前提下对乳腺癌病人进行乳房重建修复，成为乳腺外科领域重要的发展方向。乳房重建可以与全乳切除或部分乳房切除术同时进行，也可以延迟至完成辅助治疗后的适当时间进行，前者称为即刻乳房重建，后者称为延期乳房重建。临床上根据病人的疾病情况和自身的需求来确定重建时机。部分病人采用延迟-即刻乳房重建来降低辅助放疗给重建带来的不利影响，减少术后严重并发症的发生。从重建的技术手段来看，乳房重建有自体皮瓣乳房重建、假体乳房重建以及自体联合假体的乳房重建。植入物重建是即刻乳房重建中最常用的术式。在延期乳房重建中，更常采用自体皮瓣乳房重建或两步法的植入物重建术。

关键词: 即刻乳房重建, 延期乳房重建, 延期-即刻乳房重建, 自体皮瓣乳房重建, 植入物乳房重建