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find Keyword "逆序法" 4 results
  • 腋窝入路腔镜下乳腺癌根治假体结合补片在一期乳房重建中的应用

    目的介绍腋窝入路腔镜下乳腺癌根治假体结合补片一期乳房重建术的手术方法及效果。方法回顾分析 2020 年 10 月—2021 年 2 月采用腋窝入路腔镜下乳腺癌根治假体结合补片一期乳房重建的 15 例女性患者临床资料。年龄 32~52 岁,平均 43 岁。术前临床分期:0 期 3 例,Ⅰ期 3 例,Ⅱ期 9 例。肿瘤均为单发,最大径 0.7~3.2 cm,平均 2.2 cm;肿瘤距离乳头 2~6 cm,平均 3.6 cm。术前及术后 1、3 个月采用 BREAST-Q 评分量表从乳房满意度、性满意度、胸部功能及心理社会健康方面评价疗效。结果术后切口均Ⅰ期愈合;出现乳房皮肤轻度缺血 1 例、皮下积液 1 例,均未出现切口并发症、皮下气肿、乳房内血肿形成、感染、乳头乳晕表皮层坏死、皮瓣坏死、假体和/或补片取出。患者均获随访,随访时间 5.0~9.5 个月,平均 7.6 个月。随访期间未发现肿瘤复发或转移。与术前相比,术后 1 个月乳房及性满意度、胸部功能、心理社会健康评分降低(P<0.05),但术后 3 个月乳房满意度、胸部功能评分差异已无统计学意义(P>0.05),性满意度、心理社会健康评分差异仍有统计学意义(P<0.05)。结论该术式创伤小、并发症少、术后恢复快、手术时间短、重建乳房外观较好,可获得满意疗效。

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  • An innovative exploration of endoscopic nipple-sparing mastectomy combined with immediate pre-pectoral implant-based breast reconstruction with TiLoop Bra via single axillary incision for breast cancer patients

    ObjectiveTo explore the surgical technique and preliminary results of endoscopic nipple-sparing mastectomy (E-NSM) and immediate pre-pectoral implant-based breast reconstruction (BR) with titanium-coated polypropylene mesh (TiLoop Bra) via single axillary incision for breast cancer patients.MethodsThe clinical data of 9 consecutive female patients who underwent E-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra from March to May 2021 were retrospectively analyzed. The mean age of patients was 40.6 (22-60) years. The operation time, early complications were collected, and the patients' social and mental health, breast satisfaction and chest function before and after the operation were assessed with the BREAST-Q questionnaire.ResultsAll the patients had unicentric tumor with a mean diameter of 2.4 (0.6-4.7) cm. The mean distance from the tumor to the nipple was 2.5 (2-4) cm. There were 2 patients with tumor stage 0 and 7 patients with stageⅠ. The mean operation time was 161.1 (125-201) min, the mean blood loss was 41.1 mL and the hospital stay time was 1.5 d. There were 5 patients in the day-care unit. All the patients were successfully followed up with a median follow-up time of 1 (1-2) month. One (11.1%) patient with depigmentation of the nipple-areola complex caused by mild ischemia. None of the patients had incision complications, subcutaneous emphysema, hematoma, infection, nipple-areola or skin flaps necrosis, implant loss. During the follow-up period, no local/regional recurrence or distant metastasis was found. Chest well-being was decreased in the first month after the surgery compared with preoperative status, and the difference was statistically significant (P=0.001). There was no statistical difference in the breast satisfaction or psychosocial function scores between pre- and post-operation (P>0.05).ConclusionE-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra via single axillary incision has minimal trauma, rapid postoperative recovery, short operation time, few early complications and good early cosmetic effect, and the short-term result is satisfactory.

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  • A brief introduction to the clinical pathway of the endoscopic-assisted immediate implant-based breast reconstruction after nipple sparing mastectomy for breast cancer patients in day surgery center of West China Hospital

    The traditional view is that breast reconstruction is not an option for day surgery center. As a result, few hospitals in the world conduct this operation in day surgery center. Endoscopic breast reconstruction with liposuction and robot-assisted breast reconstruction are minimally invasive surgeries for breast cancer patients, but they cannot be carried out in the day surgery center due to long operation time. The novel endoscopic-assisted immediate implant-based breast reconstruction after nipple sparing mastectomy through a single axillary incision for breast cancer patients has been successfully conducted in the day surgery center in our hospital due to short operation time and small trauma. Standardized management of the complete process from the patient selection to follow-up after discharge brings rapid recovery and few complications. At the same time, the development of endoscopic surgery makes the breast almost scarless and improves aesthetic results. Therefore, the mode of endoscopic-assisted reconstruction in the day surgery center of our hospital is expected to be popularized in the whole country.

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  • Clinical application of single axillary approach reverse sequence endoscopic nipple-sparing mastectomy of breast cancer combined with subpectoral implant-based breast reconstruction on breast cancer patients

    Objective To explore the clinical and aesthetic results of single axillary approach reverse sequence endoscopic nipple-sparing mastectomy of breast cancer combined with subpectoral implant-based breast reconstruction (IBBR) for breast cancer patients. MethodsThe clinical data of consecutive female patients who underwent single axillary approach reverse sequence endoscopic nipple-sparing mastectomy of breast cancer combined with subpectoral IBBR from May 2020 to December 2022 were retrospectively analyzed. The patient demographics, perioperative parameters, complications and aesthetic results were collected. Results A total of 62 patients (74 breasts) were included. The mean age of patients was 39.0±7.8 years. The total mean operation time was 185.2±45.5 minutes. Five (8.1%) patients suffered from surgical complications. Two (3.2%) patients experienced major complications, and 3 (4.8%) suffered from minor complications. No patient experienced partial nipple-areola complex necrosis. Seventeen (27.4%) patients experienced implant related complications, of which 11 (17.7%) experienced capsular contracture. During a median follow-up time of 30 months, no patients experienced locoregional recurrence, distant metastasis and death. Thirty-seven (88.1%) patients evaluated their breasts as good or excellent. In the surgeon-reported cosmetic results, 40 (95.2%) patients achieved excellent or good results. ConclusionThe surgery is characterized by minimal trauma, short operating time, reliable safety and satisfactory aesthetic effect for small and no or mild ptosis breast patients, deserving further promotion.

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