| Objectives To analyze the clinical effects of breast cancer treated by pectoral myofascial biplanar breast reconstruction,autogenous myocutaneous flap+prosthetic breast reconstruction and biological mesh+prosthetic breast reconstruction.Methods A total of 80 breast cancer reconstruction patients who underwent surgical treatment in Tangshan People’s Hospital from January 2018 to December 2020 were divided into three groups: pectoral myofascial biplanar breast reconstruction group(n=26),autologous myocutaneous flap+prosthetic breast reconstruction group(n=26)and biological mesh+prosthetic breast reconstruction group(n=28).Collect relevant data of patients,including age,time from finding lesion to operation,location of lesion,quadrant of lesion,maximum diameter of tumor,minimum distance between tumor and nipple,pathological type,stage,axillary lymph node metastasis,breast volume removed,axillary lymph node dissection method,operation time,intraoperative blood loss,postoperative tube taking time,postoperative complications,hospitalization expenses,subjective satisfaction of patients,objective score of postoperative cosmetic effect,postoperative quality of life,etc To analyze the therapeutic effects of three groups of surgical methods.SPSS 22.0 statistical software was used for statistical analysis of data,and the measurement data were expressed by means of standard deviation(x ?s),variance analysis was used for comparison between groups,and LSD method was used for pairwise comparison.Count data is expressed in frequency(%),and nonparametric test is used for comparison between groups.P<0.05 was the difference with statistical significance.Results There were significant differences in operation time,blood loss during operation,postoperative time of taking tube and hospitalization expenses among the three groups(P<0.05).Among them,there was no significant difference in operation time and blood loss between the biplane group of pectoral muscle fascia and the biological mesh+prosthesis group,but they were lower than those of the autologous myocutaneous flap+prosthesis group In terms of postoperative tube-taking time,the biplane group of pectoralis myofasciae was lower than that of biological mesh+prosthesis group and autologous myocutaneous flap+prosthesis group,and the biological mesh+prosthesis group was lower than that of autologous myocutaneous flap+prosthesis group.In terms of hospitalization expenses,the biplane group of pectoralis myofasciae was lower than that of biological mesh+prosthesis group and autologous myocutaneous flap+prosthesis group,and the autologous myocutaneous flap+prosthesis group was lower than that of biological mesh+prosthesis group.In the pectoral myofascial biplane group,21 cases were excellent,4 cases were good and 1 case was fair,with an excellent and good rate of 96.2%.In the autogenous myocutaneous flap+prosthesis group,18 cases were excellent,6 cases were good,2 cases were fair,and the excellent and good rate was 92.3%.In the biological mesh+prosthesis group,19 cases were excellent,7 cases were good and 2 cases were fair,with an excellent and good rate of 92.9%.After comparison,there was no significant difference in postoperative satisfaction among the three groups(P>0.05).Beauty score: 11 cases scored 31-35 points,11 cases scored 26-30 points and 4 cases scored 21-25 points in the biplane group of pectoral muscle and fascia;Autologous myocutaneous flap+prosthesis group scored 31-35 in 7 cases,26-30 in 12 cases,21-25 in 6 cases and 15-20 in 1 case.In the biological mesh+prosthesis group,2 cases scored 31-35 points,13 cases scored 26-30 points,10 cases scored 21-25 points and 3 cases scored 15-20 points.The postoperative cosmetic effect of pectoral myofascial biplane group was higher than that of biological mesh+prosthesis group,the difference was statistically significant(P<0.05).The postoperative quality of life of patients in the three groups: physiological status score: the average score of pectoral myofascial biplane group is(23.15±3.08),the average score of autologous myocutaneous flap+prosthesis group is(19.92±2.26),and the average score of biological mesh+prosthesis group is(20.25±2.14).The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).Social and family status score: the average score of pectoral myofascial biplane group was(20.19±2.45),the average score of autologous myocutaneous flap+prosthesis group was(18.81±2.08),and the average score of biological mesh+prosthesis group was(18.18±1.47).The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).Emotional status score: the average score of pectoral myofascial biplane group was(23.85±1.93),the average score of autologous myocutaneous flap+prosthesis group was(13.96±4.85),and the average score of biological mesh+prosthesis group was(13.32±4.67).The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).The scores of functional status were(20.62±1.98)in the biplane group,(18.77±1.86)in the autogenous myocutaneous flap+prosthesis group and(18.82±2.23)in the biological mesh+prosthesis group.The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).Additional condition score: the average score of pectoral myofascial biplane group was(30.32±4.56),the average score of autologous myocutaneous flap+prosthesis group was(24.98±3.44),and the average score of biological mesh+prosthesis group was(25.69±4.63).The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).Total score: the average score of pectoral myofascial biplane group was(116.35±12.25),the average score of autologous myocutaneous flap+prosthesis group was(93.28±9.53),and the average score of biological mesh+prosthesis group was(97.64±11.06).The scores of pectoral myofascial biplane group were higher than those of autogenous myocutaneous flap+prosthesis group and biological mesh+prosthesis group,and the difference was statistically significant(P<0.05).Complications: Postoperative incision infection occurred in 2 cases of pectoral myofascial biplane group,3 cases of autologous myocutaneous flap+prosthesis group and 3 cases of biological mesh+prosthesis group.There was no significant difference in postoperative complications among the three groups(P >0.05).Conclusions Biplane breast reconstruction with pectoral fascia has the characteristics of short operation time,less bleeding,low operation cost,short postoperative tube taking time,good cosmetic effect and high quality of life after operation,which is worth popularizing.Figure 1;Table 6;Reference 79... |
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