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即刻和延迟两阶段乳房切除术后乳房假体重建。我们普通外科医生的经验。

Immediate and delayed two-stage post-mastectomy breast reconstruction with implants. Our experience of general surgeons.

作者信息

Racano C, Fania P L, Motta G B, Belloni C, Lazzarini E, Isoardi R, Boccù C, Duodeci S, D'Agosto M, Ragni L

机构信息

Department of General Surgery, ASL n. 15, Cittadella (PD), Italy.

出版信息

Minerva Chir. 2002 Apr;57(2):135-49.

Abstract

BACKGROUND

Breast reconstruction after a mastectomy, today is considered the best choice to improve the quality of life for the patient. The aim of the procedure is to consider the aesthetic results obtained and the various involvements, comparing them with those already reported in literature. METHODS. There is no certain data of the number of breast reconstructions performed in Italy in the few years. In 1999, in Veneto, reconstruction surgery after total breast removal, represented only 16% of the operations. In our surgery Division, from 1996 to 2000, there were breast reconstructions performed, either immediately or delayed on 87 patients out of 118 after mastectomy. 73.7% none over the age of 60 (range 27-60). The breast removal technique used is the Madden, while, for the reconstruction we have put into effect the submuscle prosthetic implant; 63 patients were subject to follow-up treatment during the period of 10 to 36 months.

RESULTS

Seventy-eight percent of the women have judged the final aesthetic results the same or better than expected. Based on reconstruction with prosthesis, is the preferred procedure, even with serious complications which do not always influence the final results. This preference is because of the reduced operation time and the psychological and physical benefits due to immediate restoral of the mammary volume and shape.

CONCLUSIONS

Some problems (Garavaglia Law) have slowed down the diffusion in Italy of this type of treatment which is now receiving more and more request and approval by the women affected with breast cancer.

摘要

背景

乳房切除术后的乳房重建如今被认为是改善患者生活质量的最佳选择。该手术的目的是考量所获得的美学效果及各种相关因素,并将其与文献中已报道的结果进行比较。

方法

近几年意大利进行乳房重建手术的具体数量尚无确切数据。1999年,在威尼托地区,全乳切除术后的重建手术仅占手术总数的16%。在我们外科科室,1996年至2000年期间,对118例乳房切除术后的患者进行了即刻或延期乳房重建手术,共87例。其中73.7%的患者年龄在60岁以下(年龄范围为27至60岁)。所采用的乳房切除技术是马登术式,而在重建方面,我们实施了肌下假体植入;63例患者在10至36个月期间接受了随访治疗。

结果

78%的女性认为最终美学效果与预期相同或优于预期。基于假体的重建是首选手术方式,即便存在严重并发症,但这些并发症并不总是会影响最终结果。这种偏好源于手术时间缩短以及因乳房体积和形状的即刻恢复所带来的心理和生理益处。

结论

一些问题(加拉瓦利亚法则)减缓了此类治疗在意大利的推广,不过现在越来越多的乳腺癌女性对此有需求并予以认可。

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