mastectomy alone

Excision of breast tissue, nipple and superficial skin and pectoralis major fascia. This method is suitable for non-invasive cancer, micro-cancer, eczema-like cancer, limited to nipples, can also be used for elderly patients who are not suitable for radical surgery, or because of large tumors or ulceration, bleeding combined with radiation therapy. Treatment of diseases: breast sarcoma breast cancer Indication 1. Large or multiple benign tumors in the breast. 2. Intraductal papilloma or proliferative chronic cystic breast disease with a wide range of lesions, older age and malignant transformation. 3. Severe breast tuberculosis is associated with multiple sinus and long-term unhealed. 4. Breast sarcoma. 5. Advanced breast cancer with local ulcers, should not be used for radical mastectomy (preoperative and post-operative with chemical drugs and radiation therapy). Contraindications One of the following conditions is not suitable for surgery: 1. There is extensive edema in the breast and its surrounding skin, and its range is more than half of the breast area. 2. The mass is fixed with the chest wall. 3. The axillary lymph nodes are significantly enlarged and have been closely adhered to the deep tissues, or the upper limbs have edema or shoulder pain. 4. There are satellite nodules in the breast and its surrounding skin. 5. Metastasis of the supraclavicular lymph nodes. 6, inflammatory breast cancer. 7, there has been a distant transfer. Preoperative preparation The scope of surgical field preparation is the ipsilateral chest and supraclavicular region and armpit. Shave the mane. For tuberculous lesions, anti-tuberculosis treatment should be performed before surgery. Surgical procedure 1. Position: supine position, the upper limb of the affected side is abducted 90° and fixed on the limb rest of the operating table. Be careful not to over-extension, prevent brachial plexus paralysis, and use the soft pillow to raise the chest by about 5cm. 2. There are two kinds of incisions: (1) Taking a nipple as the center, between the 2nd to 6th ribs, a slanting fusiform incision is made from the outside to the inside. If breast cancer is present, the incision should be 4 to 5 cm from the edge of the tumor. The separation flap is the same as the simplified radical surgery, and the breast is finally removed together with the subcutaneous fat. Non-malignant lesions simply remove the breast. (2) A transverse shuttle-shaped incision is made centering on the nipple. When selecting the incision, lift the breast as much as possible, draw a horizontal line with the methylene blue under the areola, and then lower the breast as much as possible. Also draw a horizontal line above the areola (tumor). These two lines can move up and down according to the lesion position. After the breast is restored to its original position, it means a transverse shuttle-shaped incision line. 3. Resection of the breast: the skin is cut through the incision line, and the extent and extent of the subcutaneous fat tissue depends on the nature of the lesion. From the 2nd to 3rd ribs in the separation range, down to the 6th to 7th ribs, inside the sternum, and outside the front line. After the skin on one side was separated, the hemostatic was filled with hot saline gauze. Then separate the other side of the skin. Then along the upper edge of the breast, cut around the base of the breast, stop bleeding, and cut straight to the pectoralis major fasciitis. Use a tissue forceps to pull the breast down and use a sharp knife to cut the entire breast and surrounding adipose tissue from the pectoralis major fascia. If breast cancer or breast sarcoma, the pectoralis major fascia should be removed at the same time. When cutting, the blood vessels that are worn by the chest wall should be ligated one by one. 4. Drainage suture: In order to avoid exudation and hemorrhage after surgery, affect healing and increase the chance of infection, make a small incision outside the incision. When the irrigation is completed, put a soft rubber tube to drain and fix it on the skin. Layered suture without skin grafting. The incision was pressure wrapped with a cotton pad. complication Lymphangiitis.

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