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由于保乳手术后的术后并发症而延迟辅助放疗。

Delay of adjuvant radiotherapy due to postoperative complications after oncoplastic breast conserving surgery.

机构信息

Department of Plastic, Reconstructive & Hand Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.

Department of Plastic, Reconstructive & Hand Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.

出版信息

Breast. 2018 Jun;39:110-116. doi: 10.1016/j.breast.2018.04.005. Epub 2018 Apr 12.

Abstract

BACKGROUND

In the past a mastectomy was the first approach of treating breast cancer. Oncoplastic techniques combined with breast conserving surgery (BCS) and radiotherapy has become an alternative to mastectomy in patients with non-metastasized breast cancer. The aim of this study was to analyse the amount and types of complications occurring after oncoplastic BCS before and after adjuvant radiotherapy and the delay of adjuvant therapy due to the complications.

METHOD

A retrospective study based on all patients who received immediate oncoplastic BCS by a plastic surgeon at two medical hospitals in The Netherlands between 2013 and 2015. (n = 150). The performed oncoplastic BCS techniques were the primary outcome measures. In particular major complications with the need for antibiotics or surgical intervention. A one-year follow-up was achieved for all patients.

RESULTS

52% of the 150 included patients received an oncoplastic BCS through the reduction pattern, 35% with a LICAP and 10% with an AICAP. Complications occurred in 37.5% of the patients, 10% of the patients needed treatment with antibiotics and in 6.6% of the patients a revision operation was indicated. 79.6% of all postoperative complications occurred before the start of adjuvant radiotherapy. In 8.2% of the patients the adjuvant radiotherapy had to be delayed due to a complication.

CONCLUSION

This study provides a detailed overview of the used techniques of oncoplastic BCS and their postoperative complications. Most complications occurred before the start of the adjuvant radiotherapy. Just a small amount caused a delay for the radiotherapy to start.

摘要

背景

过去,乳房切除术是治疗乳腺癌的首选方法。肿瘤整形技术与保乳手术(BCS)和放疗相结合,已成为非转移性乳腺癌患者乳房切除术的替代方法。本研究旨在分析辅助放疗前后接受肿瘤整形保乳手术后并发症的数量和类型,以及因并发症而导致辅助治疗延迟的情况。

方法

本研究为回顾性研究,纳入了 2013 年至 2015 年间荷兰两家医院的一名整形外科医生为患者实施的即时肿瘤整形保乳术(n=150)。主要研究终点为实施的肿瘤整形保乳术技术。特别关注需要抗生素或手术干预的主要并发症。所有患者均进行了为期一年的随访。

结果

150 例纳入患者中,52%接受了缩小成形术的肿瘤整形保乳术,35%接受了 LICAP,10%接受了 AICAP。37.5%的患者出现并发症,10%的患者需要抗生素治疗,6.6%的患者需要进行修正手术。79.6%的术后并发症发生在辅助放疗开始前。8.2%的患者因并发症而延迟接受辅助放疗。

结论

本研究详细介绍了肿瘤整形保乳术的技术及其术后并发症。大多数并发症发生在辅助放疗开始前。只有一小部分并发症导致放疗开始延迟。

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