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首页> 外文期刊>Journal of Cancer Research and Treatment >Management of Radiotherapy-induced-local Surgical Complications after surgery for Breast Cancer; A Single Institute Experience
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Management of Radiotherapy-induced-local Surgical Complications after surgery for Breast Cancer; A Single Institute Experience

机译：乳腺癌术后放疗引起的局部手术并发症的处理;单一学院经历

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Background: Radiation therapy (RT) is an integral component of the management of breast cancer. During RT delivery most of breast cancer patients experience adverse reactions; Most of these reactions are usually not severe enough to cause disabilities that affect their usual daily activities. Irradiation of the chest wall or reconstructed breast may result in changes in the treated soft tissues and skin that may compromise the cosmetic outcome. This study aimed to describe the management of Radiotherapy-induced-local surgical complications after surgery for breast cancer at our institution. Patients and Methods: This study included patients with breast cancer who developed radiotherapy-induced local surgical complications for which these patients were admitted to the department of Surgery, Alexandria Medical Research Institute hospital during the period between January 2015 and June 2016. The complications were classified as minor or major. The minor complications included complications which were managed conservatively or by minor surgical procedure while the major complications were those which needed reoperation for management. Results: This study included 49 patients of whom 22 patients (45%) had SSM with immediate breast reconstruction with implant, 12 patients (24.4%) had NSM with immediate breast reconstruction with implant, 10 patients (20.4%) had MRM and 5 patients (10.2%) had CBS. Thirty two patients (65.3%) developed minor complications which included capsular contracture (Baker1-2), seroma, minor skin infection and minor wound dehiscence; They were managed conservatively or by minor surgical procedures as analgesics, supporting bra, seroma aspiration, antibiotics after culture and sensitivity testing or debridement and secondary suturing. Seventeen patients (34.7%) had major complications which included capsular contracture (Baker 3-4), Severe infection, major wound dehiscence and radiation burn and/or Ulcer; they needed reoperation for management which varied between excision of all radiated skin without reconstruction and excision of all radiated skin and correction by TRAM. Conclusions: Radiotherapy-induced local surgical complications after surgery for breast cancer are not uncommon, can cause major adverse events and can occur after any type of surgery for breast cancer. Luckily; most of them are minor and can be managed conservatively or by minor surgical procedure. The oncoplastic breast surgeon should be ready to deal with these complications with different options to decrease morbidity and to regain better cosmetic outcome.
机译：背景：放射治疗（RT）是乳腺癌治疗不可或缺的组成部分。在分娩期间，大多数乳腺癌患者会发生不良反应。这些反应中的大多数通常不够严重，无法引起影响其日常活动的残疾。照射胸壁或重建的乳房可能会导致经治疗的软组织和皮肤发生变化，从而可能损害美容效果。这项研究的目的是描述我们机构对乳腺癌术后放疗引起的局部手术并发症的处理方法。患者和方法：本研究包括患有放疗引起的局部手术并发症的乳腺癌患者，这些患者在2015年1月至2016年6月期间入院亚历山大医院医学研究所外科。作为次要或主要。轻微并发症包括保守治疗或通过较小外科手术处理的并发症，而主要并发症是需要再次手术治疗的并发症。结果：该研究包括49例患者，其中22例（45％）的SSM植入即刻乳房重建术，12例（24.4％）的NSM植入即刻乳房重建术，10例（20.4％）患有MRM和5例患者（10.2％）有CBS。 32例患者（65.3％）发生了轻微并发症，包括包膜挛缩（Baker1-2），血清肿，轻微皮肤感染和轻微伤口裂开。他们采取保守治疗或通过少量外科手术作为镇痛剂进行管理，以支持胸罩，浆液抽吸，培养和敏感性测试或清创和二次缝合后使用抗生素。 17例患者（34.7％）有严重并发症，包括包膜挛缩（Baker 3-4），严重感染，严重伤口裂开，放射线烧伤和/或溃疡。他们需要进行再次手术以进行管理，这在不切除所有放射皮肤而切除所有放射皮肤以及切除和使用TRAM进行矫正之间有所不同。结论：乳腺癌术后放疗引起的局部手术并发症并不少见，可引起重大不良事件，并且在任何类型的乳腺癌手术后均可发生。幸运的是它们中的大多数是较小的，可以保守治疗或通过较小的外科手术进行处理。肿瘤整形外科医生应准备好以各种选择来应对这些并发症，以降低发病率并获得更好的美容效果。

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