早期乳腺癌采用常规保乳手术与整形保乳手术治疗的临床效果分析
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摘要
目的比较早期乳腺癌采取常规保乳手术与整形保乳手术治疗的临床效果和安全性,为并发症更少、局部美容效果更好、安全有效的保乳术式提供参考。方法选取2015年6月-2017年5月于中山大学附属第一医院进行保乳手术治疗的60例早期乳腺癌患者随机分为观察组和对照组各30例,观察组实施整形保乳术,对照组给予常规保乳术,对比两组患者手术情况、手术效果及安全性。结果观察组患者术中出血量、术后引流量及住院时间均少于对照组患者,差异有统计学意义(P<0.05)。观察组与对照组术中切除乳腺标本量分别为(72.5±10.3)g和(46.4±8.2)g,肿瘤距切缘最近距离分别为(13.5±2.7)mm和(10.4±1.9)mm,术后并发症发生率分别为10.0%和33.3%,乳房整形效果优良率分别为36.7%和13.3%,两组差异均有统计学意义(P<0.05)。结论与常规保乳术相比,整形保乳术切除的乳腺组织量更大、切除范围更广、术后并发症更少、局部美容效果更好,是一种安全有效、值得在临床中推广的保乳术式。
Objective To compare the clinical effects and safeties of routine breast conservative surgery and oncoplastic breast-conserving therapy in treatment of early breast cancer,provide reference for breast conservative surgery with less complications,better local cosmetic effect,higher safety and effectiveness. Methods From June 2015 to May 2017,60 early breast cancer patients receiving breast conservative surgery in the First Affiliated Hospital of Sun Yat-sen University were selected and randomly divided into observation group and control group,30 patients in each group. The patients in observation group were treated by oncoplastic breast-conserving therapy,and the patients in control group were treated by routine breast conservative surgery. The operation situations,curative effects,and safeties in the two groups were compared. Results The amount of intraoperative blood loss,the amount of postoperative drainage,and hospitalization time in observation group were statistically significantly less than those in control group( P<0. 05). The amount of resection of breast specimens in observation group and control group were( 72. 5±10. 3) g and( 46. 4±8. 2) g,respectively; the nearest distances from tumor to cut edge in observation group and control group were( 13. 5±2. 7) mm and( 10. 4±1. 9) mm,respectively; the incidence rates of postoperative complications in observation group and control group were 10. 0% and 33. 3%,respectively; the excellent and good rate of cosmetic effect in observation group and control group were 36. 7% and 13. 3%,respectively; there were statistically significant differences between the two groups( P <0. 05). Conclusion Compared with routine breast conserving surgery,oncoplastic breast-conserving therapy has the advantages of higher amount of resection of breast specimens,wider resection range,less postoperative complications,and better local cosmetic effect. The method is safe and effective,which is worthy of clinical promotion.
Objective To compare the clinical effects and safeties of routine breast conservative surgery and oncoplastic breast-conserving therapy in treatment of early breast cancer,provide reference for breast conservative surgery with less complications,better local cosmetic effect,higher safety and effectiveness. Methods From June 2015 to May 2017,60 early breast cancer patients receiving breast conservative surgery in the First Affiliated Hospital of Sun Yat-sen University were selected and randomly divided into observation group and control group,30 patients in each group. The patients in observation group were treated by oncoplastic breast-conserving therapy,and the patients in control group were treated by routine breast conservative surgery. The operation situations,curative effects,and safeties in the two groups were compared. Results The amount of intraoperative blood loss,the amount of postoperative drainage,and hospitalization time in observation group were statistically significantly less than those in control group( P<0. 05). The amount of resection of breast specimens in observation group and control group were( 72. 5±10. 3) g and( 46. 4±8. 2) g,respectively; the nearest distances from tumor to cut edge in observation group and control group were( 13. 5±2. 7) mm and( 10. 4±1. 9) mm,respectively; the incidence rates of postoperative complications in observation group and control group were 10. 0% and 33. 3%,respectively; the excellent and good rate of cosmetic effect in observation group and control group were 36. 7% and 13. 3%,respectively; there were statistically significant differences between the two groups( P <0. 05). Conclusion Compared with routine breast conserving surgery,oncoplastic breast-conserving therapy has the advantages of higher amount of resection of breast specimens,wider resection range,less postoperative complications,and better local cosmetic effect. The method is safe and effective,which is worthy of clinical promotion.
引文
[1]陈计赏,李晓文,林显君,等.乳房整形技术在乳腺癌保乳手术中的可行性及美容效果[J].中华肿瘤防治杂志,2017,12(5):121-126.
[2]张永辉,王勇,孙小虎,等.个体化乳腺癌保乳术165例临床分析[J].临床肿瘤学杂志,2016,21(3):257-261.
[3]王金玲.整形保乳术与常规保乳术治疗早期乳腺癌临床对比研究[J].中外医疗,2016,35(24):72-76.
[4]徐平,曹卫.整形保乳术在早期乳腺癌治疗中的安全性及有效性分析[J].中国美容医学,2017,26(2):39-41.
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[6]张雪惠,陈月凤,薛小军,等.整形保乳术与常规保乳术治疗早期乳腺癌比较[J].现代仪器与医疗,2017,23(2):39-53.
[7]曹勇,罗杰,周鑫,等.肿瘤整形技术在早期乳腺癌保乳手术中的临床应用[J].中国普通外科杂志,2017,26(5):607-613.
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[9]姜润学,蔡海峰,胡万宁,等.近乳晕区早期乳腺癌整形保乳术30例临床研究[J].中国肿瘤临床,2015,42(2):112-115.
[10]唐玮,刘剑仑,杨华伟,等.整形保乳术与常规保乳术在早期乳腺癌治疗中的比较分析[J].中国肿瘤临床,2016,43(6):235-239.
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[12]Down SK,Jha PK,Burger A,et al.Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer[J].Breast J,2013,19(1):56-63.
[13]Park CC,Mitsumori M,Nixon A,et al.Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer:influence of margin status and systemic therapy on local recurrence[J].J Clin Oncol,2000,18(8):1668-1675.
[14]李如杰,范鹏举,周超,等.乳腺癌保乳手术中乳房整形技术的临床效果观察[J].中外医学研究,2015,13(19):60-62.
[15]陈正新.整形保乳术在早期乳腺癌治疗中的应用效果及安全性分析[J].当代医学,2018,18(4):120-124.
[2]张永辉,王勇,孙小虎,等.个体化乳腺癌保乳术165例临床分析[J].临床肿瘤学杂志,2016,21(3):257-261.
[3]王金玲.整形保乳术与常规保乳术治疗早期乳腺癌临床对比研究[J].中外医疗,2016,35(24):72-76.
[4]徐平,曹卫.整形保乳术在早期乳腺癌治疗中的安全性及有效性分析[J].中国美容医学,2017,26(2):39-41.
[5]杨卉.乳腺肿瘤整形保乳手术治疗早期乳腺癌临床效果及安全性研究[J].世界最新医学信息文摘,2016,16(90):105.
[6]张雪惠,陈月凤,薛小军,等.整形保乳术与常规保乳术治疗早期乳腺癌比较[J].现代仪器与医疗,2017,23(2):39-53.
[7]曹勇,罗杰,周鑫,等.肿瘤整形技术在早期乳腺癌保乳手术中的临床应用[J].中国普通外科杂志,2017,26(5):607-613.
[8]曹旭晨.整形保乳手术---乳腺外科个体化治疗的新方向[J].中国普外基础与临床杂志,2013,20(8):838-841.
[9]姜润学,蔡海峰,胡万宁,等.近乳晕区早期乳腺癌整形保乳术30例临床研究[J].中国肿瘤临床,2015,42(2):112-115.
[10]唐玮,刘剑仑,杨华伟,等.整形保乳术与常规保乳术在早期乳腺癌治疗中的比较分析[J].中国肿瘤临床,2016,43(6):235-239.
[11]贺强.肿瘤整形外科技术在乳腺癌保乳术中的研究进展[D].重庆医科大学,重庆2016.
[12]Down SK,Jha PK,Burger A,et al.Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer[J].Breast J,2013,19(1):56-63.
[13]Park CC,Mitsumori M,Nixon A,et al.Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer:influence of margin status and systemic therapy on local recurrence[J].J Clin Oncol,2000,18(8):1668-1675.
[14]李如杰,范鹏举,周超,等.乳腺癌保乳手术中乳房整形技术的临床效果观察[J].中外医学研究,2015,13(19):60-62.
[15]陈正新.整形保乳术在早期乳腺癌治疗中的应用效果及安全性分析[J].当代医学,2018,18(4):120-124.