摘要
目的 探究乳腺癌根治术后,即刻乳房重建与延迟重建的并发症发生率和相关影响因素.方法 本研究为回顾性研究.按照纳入与排除标准,搜集2016年1月—2022年3月,在本中心行保留乳头乳晕的乳腺癌根治术及假体乳房重建术的早期女性乳腺癌患者94例的病例资料为研究对象.按照乳房重建时间分为即刻重建组52例、延迟重建组42例.比较两组患者的年龄、手术距首次治疗时间、是否绝经、肿瘤位置、肿瘤数量、TNM分期、组织类型、分子亚型、假体大小、治疗方式、住院时间、手术时长、手术出血量、引流管留置时间、并发症等临床特征差异;计量资料中符合正态分布的采用t检验、不符合者采用Mann-Whitney U秩和检验,计数资料采用χ2检验,采用二元Logistic回归模型评估重建方式对术后并发症发生率的影响.结果 即刻重建组TNM分期0～Ⅲ期分别为19、29、6、0例,延迟重建组分别为8、13、17、6例,两组患者的乳腺癌TNM各分期占比差异显著,均有统计学意义(P均＜0.001).即刻重建组患者接受淋巴结清扫、术后放射治疗的占比明显低于延迟重建组,差异均有统计学意义(P均＜0.001);治疗方式中使用补片的占比较高,差异有统计学意义(P=0.001).两组患者并发症发生率、二次手术率、重建失败率差异比较无统计学意义(P均＞0.05).结论 乳腺癌根治术后即刻乳房重建术对乳腺癌患者效果显著,术后并发症发生率与延迟重建术相当.
Abstract
Objective To explore the incidence of complications and related influencing factors in immediate breast reconstruction with prosthesis and delayed reconstruction after radical mastectomy for breast cancer.Methods This retrospective study included 94 female early breast cancer patients who underwent nipple-areola sparing mastectomy and breast reconstruction with prosthesis in our center from January 2016 to March 2022.The patients were divided into the immediate reconstruction group(52 cases)and the delayed reconstruction group(42 cases)based on the reconstruction time.Clinical characteristics,including age,time from surgery to initial treatment,menopausal status,tumor location,tumor quantity,TNM stage,histological type,molecular subtype,implant size,treatment method,length of hospital stay,duration of surgery,intraoperative blood loss,drainage tube retention time,and complications,were compared between the two groups.Statistical analysis was performed using t-tests for normally distributed continuous data,Mann-Whitney U tests for non-normally distributed continuous data,and χ2 tests for categorical data.Binary logistic regression models were employed to assess the impact of reconstruction methods on the incidence of postoperative complications.Results TNM stages 0～Ⅲ between the two groups were 19,29,6,0 in immediate construction group,and 8,13,17,6 in delayed construction group.There were significant differences in the distribution of TNM stages between the two groups(all P<0.001).The proportion of patients in the immediate reconstruction group who underwent lymph node dissection and postoperative radiotherapy was significantly lower than that in the delayed reconstruction group,with statistically significant differences(all P<0.001).The use of acellular dermal matrix was more common in the treatment method,with a statistically significant difference(P=0.001).There were no statistically significant differences in the incidence of complications,reoperation rate,and reconstruction failure rate between the two groups(all P>0.05).Conclusion Immediate breast reconstruction after raidcal mastectomy for breast cancer was effective for breast cancer patients,which was comparable to that of delayed construction.
维普
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