目的

探讨并分析保留皮肤乳腺切除术后应用Becker可扩张假体或Mentor 光面假体植入即刻乳房再造的手术方法、效果及并发症。

方法

本组共96 例，行保留皮肤的乳腺切除术后，再行Becker可扩张假体或Mentor光面假体植入即刻乳房再造，其中Mentor光面假体植入68例，可扩张假体植入28例。 本组有30例患者保留乳头、乳晕。 根据乳房的体积、形状、与对侧乳房的对称性比较及患者满意情况，评价手术效果。

结果

效果优29 例，良47 例，一般12 例，差8 例。 并发症发生率为12.5% 。

结论

假体植入即刻乳房再造安全可靠，手术效果好，并发症少，适用于早期乳腺癌患者。 选择性保留乳头、乳晕并不增加局部复发的风险。 手术成功的关键在于病例的选择，乳腺癌根治切口设计及术中、术后的处理。

Objective

To explore and evaluate the technique， outcome and complications of immediate breast reconstruction （IBR） with Becker expandable and Mentor breast implant after skin-sparing mastectomy （SSM） in patients with stage Ⅰ and Ⅱ breast cancer.

Methods

Ninety-six clinical cases were retrospectively studied， in which IBR with Becker expandable prostheses or Mentor prostheses after SSM was carried out.Of the 96 implants used in our series， 68 were permanent breast implants， and 28 Becker expandable breast implants.Of the 96 cases， 30 had IBR after SSM with the conservation of NAC.Aesthetic outcomes were assessed according to the breast volume， shape and symmetry with the opposite breasts and patients'satisfaction.

Results

The aesthetic outcomes were graded as excellent in 29 patients， good in 47 patients， fair in 12 patients and poor in 8 patients.The overall complication rate was 12.5% （12 of 96）.

Conclusions

This study demonstrates that prosthetic reconstruction is a safe， reliable method with minimal complication， good to excellent aesthetic results in majority of patients of breast cancer in early stage.In selected patients， NAC sparing mastectomy can be performed without increasing the risk of local recurrences.Success depends on patient selection， ideal incision for skin-sparing mastectomy， full-muscular coverage of the prostheses and careful intraoperative and postoperative management.