皮肤节约性乳房切除术和即时植入式基础的重建:重新评估
Melika Zarei1, Grant W Carlson
1From the Division of Plastic Surgery, Emory University School of Medicine, Atlanta GA.
Annals of plastic surgery
|June 10, 2024
概括
节省皮肤的乳房切除术 (SSM) 采用方形乳头-乳腺膜综合体 (NAC) 切除和X形闭合是乳房重建的可行技术. 双阶段组织扩展器重建可降低乳房切除术皮肤死 (MSFN) 风险.
科学领域:
- 整形外科 整形外科 整形外科
- 乳房重建 乳房重建
- 瘤外科手术 瘤外科手术
背景情况:
- 节省皮肤的乳房切除术 (SSM) 是一种瘤塑料技术,用于节省乳头的乳房切除术 (NSM) 由于瘤位置而不可行.
- 乳头 - 腹膜复合体 (NAC) 切除和关闭方法可以影响重建结果.
研究的目的:
- 为了评估SSM的结果,使用方形NAC切除和X形囊串关闭与立即植入物基础的重建.
- 为了比较组织扩展器 (TE) 和直接植入 (DTI) 重建方法之间的并发症率,特别是乳房切除皮肤死 (MSFN).
主要方法:
- 从2015年1月到2022年12月,对从2015年1月到2022年12月接受周围耳膜SSM并立即进行植入物重建的患者进行回顾性评估.
- 纳入标准侧重于患有方形NAC切除和皮肤闭合的患者.
- 数据分析包括并发症率 (MSFN,感染) 和重建性失败,按重建方法分层 (TE与DTI).
主要成果:
- 29名患者 (54个乳房) 接受了癌症或预防性原因的手术.
- 整体伤口并发症发生在24.1%的乳房中,MSFN在18.5%和感染在5.6%中.
- 与组织扩展器 (TE) 组 (11.1%) (P=0.05) 相比,直接植入 (DTI) 组 (33.3%) 的MSFN率显著更高.
结论:
- 采用X形闭合的方形NAC切除术是通过植入物重建来最大限度地减少SSM切口的技术.
- 两个阶段的TE重建允许较低的初始填充量,减少MSFN风险与DTI相比.
- 这种技术适用于小到中等尺寸的乳房,在不符合NSM条件的患者中,乳房有轻微的死.
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