摘要目的 探讨异种脱细胞真皮结合假体应用于保留皮肤的乳腺癌手术即刻乳房再造术的手术方法及临床效果.方法 分析2015年1月至2017年6月进行保留皮肤乳腺癌改良根治术后即刻假体再造43例的临床资料.将43例患者分为两组:A组为肌瓣+假体组(18例),B组为肌瓣+生物补片+假体组(25例),所有患者均为单侧手术,两组间一般资料差异无统计学意义(P＞0.05).结果 术后随访中位时间为18.7个月(3～28个月).引流总量A组平均为(523.17±62.18) ml,B组平均为(639.56±54.34) ml,差异有统计学意义(P＜0.05).A组平均引流拔管时间为(7.83±1.58)d,B组为(10.2±1.44)d,差异有统计学意义(P＜0.05).结论 异种脱细胞真皮结合假体应用于保留皮肤的乳腺癌手术即刻乳房再造术,手术安全、有效.

abstractsObjective To explore the clinical outcomes of xenogenic acellular dermal matrix in immediate implant-based breast reconstruction following nipple/skin sparing mastectomy.Methods From January 2015 to June 2017,patients that underwent immediate implant-based breast reconstruction following nipple/skin-sparing mastectomy were retrospectively studied.Results 43 female patients with breast cancer were enrolled.A retrospective review was performed on patients that were reconstructed with either alloplastic reconstruction (group A,18 breasts) or xenogenic acellular matrix dermal (group B,25 groups).Differences in the average age,body mass index,numbers of diabetic patients,numbers of active smoker,and volume of implant between the two groups were not statistically significant (P＞0.05).All patients were followed up from 3 to 28 months,with the middle time of 18,7 months.Complications in both groups of patients were clinically recorded after operation.When comparing clinical outcomes,group A had fewer drain (523.17±62.18) ml vs (639.56±54.34)ml,and fewer days before drain removal (7.83±1.58) d vs (10.2±1.44) d.No significant difference was seen in terms of seroma,hematoma,delayed healing,infection,nipple necrosis,capsular contracture,or tumor recurrence.Conclusions The use of xenogenic acellular matrix dermal in immediate implant-based breast reconstruction following nipple/skin-sparing mastectomy is as safe and effective as alloplastic reconstruction.