文献类型：期刊文献

中文题名：传统术式与腔镜背阔肌肌瓣乳房重建术治疗中小乳房早期乳腺癌效果比较

英文题名：Outcome of conventional versus endoscopic latissimus dorsi breast reconstruction for early breast cancer in patients with small-to-medium sized breasts

作者：程陆洋[1];关洁芳[2];刘莉[2];李宏敏[2];尚天禄[2];赖杨素[1];刘立汉[2];张宏都[2]

第一作者：程陆洋

机构：[1]甘肃中医药大学公共卫生学院,甘肃兰州730000;[2]甘肃中医药大学第三附属医院胸外乳腺科,甘肃白银730900

第一机构：甘肃中医药大学公共卫生学院

年份：2025

卷号：39

期号：6

起止页码：534

中文期刊名：中华实用诊断与治疗杂志

外文期刊名：Journal of Chinese Practical Diagnosis and Therapy

语种：中文

中文关键词：乳腺癌;腔镜;乳房重建;背阔肌;肌瓣

外文关键词：breast cancer;endoscopy;breast reconstruction;latissimus dorsi;dorsi flap

摘要：目的比较中小乳房早期乳腺癌患者采用传统术式与腔镜背阔肌肌瓣乳房重建术治疗的效果及安全性。方法2021年1月—2023年8月甘肃中医药大学第三附属医院诊治中小乳房早期乳腺癌患者40例,均行背阔肌乳房重建术,根据手术方式分为传统组21例和腔镜组19例,比较2组患者手术时间及术后住院时间、术中出血量、术后引流量、术后并发症发生情况。随访截至2023年12月,评估2组术后生活质量[欧洲癌症研究与治疗组织生活质量问卷-乳腺癌模块(QLQ-BR23)症状维度评分、QLQ-BR23功能维度评分]、美学效果[日本乳腺癌协会(JBCS)美学量表评分及美学优良率],采用BREAST-Q量表评估患者乳房满意度。结果腔镜组手术时间[(405.58±32.01)min]长于传统组[(377.43±35.53)min](t=-2.622,P=0.013),术中出血量[(25.79±3.14)mL]、术后引流量[(207.11±38.98)mL]均少于传统组[(41.19±2.25)、(292.81±16.69)mL](t=17.978,P<0.001;t=9.197,P<0.001),术后住院时间[(7.21±1.08)d]短于传统组[(9.05±1.69)d](t=4.047,P<0.001),术后并发症发生率(5.3%)低于传统组(38.1%)(χ^(2)=4.427,P=0.035)。中位随访时间6个月,腔镜组QLQ-BR23症状维度评分[(67.99±16.12)分]低于传统组[(81.57±8.65)分](t=3.361,P=0.002),JBCS美学量表评分[(9.32±1.32)分]、美学优良率(89.5%)及BREAST-Q评分[(73.87±6.60)分]均高于传统组[(7.76±0.82)分、57.1%、(62.63±4.91)分](t=-4.519,P<0.001;χ^(2)=5.230,P=0.022;t=-6.153,P<0.001),QLQ-BR23功能维度评分[(89.15±7.90)分]与传统组[(84.82±6.19)分]比较差异无统计学意义(t=-1.937,P=0.060)。结论腔镜背阔肌肌瓣乳房重建术治疗中小乳房早期乳腺癌具有术后恢复时间短、并发症发生率低、美学效果好、患者乳房满意度高的优势。
Objective To compare the outcome and safety of conventional versus endoscopic latissimus dorsi breast reconstruction for early breast cancer in patients with small-to-medium sized breasts.Methods Forty early breast cancer patients with small-to-medium sized breasts were diagnosed treated in the Third Affiliated Hospital of Gansu University of Chinese Medicine from January 2021 to August 2023,and all patients underwent latissimus dorsi breast reconstruction.According to the surgical method,40 patients were divided into a conventional group(n=21)and an endoscopic group(n=19).The surgical duration,length of postoperative hospital stay,intraoperative blood loss,postoperative drainage volume and occurrence of postoperative complications were compared between the two groups.The patients were followed up until December 2023.The postoperative quality of life was assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module(QLQ-BR23)questionnaire(symptom and functional scale scores),the aesthetic outcomes were evaluated using Japanese Breast Cancer Society(JBCS)scale and aesthetic excellent/good rate,and the patient's satisfaction with breast reconstruction was assessed using BREAST-Q questionnaire.Results The surgical duration was longer in the endoscopic group[(405.58±32.01)min]than that in the conventional group[(377.43±35.53)min](t=-2.622,P=0.013),the intraoperative blood loss and postoperative drainage were less in the endoscopic group[(25.79±3.14),(207.11±38.98)mL]than those in the conventional group[(41.19±2.25),(292.81±16.69)mL](t=17.978,P<0.001;t=9.197,P<0.001),the length of postoperative hospital stay was shorter in the endoscopic group[(7.21±1.08)d]than that in the conventional group[(9.05±1.69)d](t=4.047,P<0.001),and the incidence of postoperative complications was lower in the endoscopic group(5.3%)than that in the conventional group(38.1%)(X^(2)=4.427,P=0.035).At a median follow-up time of 6 months,the QLQ-BR23 symptom scale score was lower in the endoscopic group(67.99±16.12)than that in the conventional group(81.57±8.65)(t=3.361,P=0.002),the JBCS score,aesthetic excellence/good rate and BREAST-Q score were higher in the endoscopic group(9.32±1.32,89.5%,73.87±6.60)than those in the conventional group(7.76±0.82,57.1%,62.63±4.91)(t=-4.519,P<0.001;X^(2)=5.230,P=0.022;t=-6.153,P<0.001),and there was no statistically significant difference in the QLQ-BR23 functional scale score between two groups(89.15±7.90 vs 84.82±6.19)(t=-1.937,P=0.060).Conclusion Endoscopic latissimus dorsi breast reconstruction for early breast cancer in patients with small-to-medium sized breasts has the advantages of quick postoperative recovery,low complication rate,good aesthetic effect,and high patients'satisfaction.