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波兰综合征:18例患者的不同临床表现及手术重建

Poland's syndrome: different clinical presentations and surgical reconstructions in 18 cases.

作者信息

Freitas Renato da Silva, o Tolazzi André Ricardo Dall'Ogli, Martins Vanessa Dello Mônaco, Knop Breno Albuquerque, Graf Ruth Maria, Cruz Gilvani Azor de Oliveira E

机构信息

Plastic and Reconstructive Surgery Unit, Hospital de Clínicas of Federal University of Paraná, R. General Carneiro, Curitiba-PR, Brazil 80060-900.

出版信息

Aesthetic Plast Surg. 2007 Mar-Apr;31(2):140-6. doi: 10.1007/s00266-005-0140-y.

Abstract

BACKGROUND

The literature reports many variations of Poland's syndrome. This article describes 18 cases of Poland's syndrome in different stages of treatment, with variable clinical presentations and reconstructive techniques.

METHODS

This study evaluated 15 females and 3 males, ages 2 to 43 years, for breast deformity, nipple-areolar complex position, pectoralis muscle malformation, thoracic deformities, and the presence of brachysyndactyly. Surgical treatment was performed for 14 patients, individualized for each case.

RESULTS

For the women, the hypoplastic breast was treated with a latissimus dorsi muscular flap associated with silicone gel implant in five cases. Two other patients still are receiving tissue expansion for a future muscular and prosthetic reconstruction. Prosthetic implants alone were used on the affected side in four cases. The nipple-areolar complex was reconstructed for two patients. Seven women underwent contralateral breast surgery: reduction mammoplasty in three cases, mastopexy in two cases, and prosthetic implants in two cases. The only man who underwent surgery was treated with endoscopic rotation of the latissimus dorsi muscle flap.

CONCLUSIONS

This study demonstrated several breast reconstruction options for patients with Poland's syndrome, reinforcing the importance of an individualized treatment to achieve complete and adequate rehabilitation.

摘要

背景

文献报道了波兰综合征的多种变异情况。本文描述了18例处于不同治疗阶段的波兰综合征病例,其临床表现和重建技术各不相同。

方法

本研究评估了15名女性和3名男性,年龄在2至43岁之间,观察其乳房畸形、乳头乳晕复合体位置、胸肌畸形、胸廓畸形以及并指畸形的情况。对14例患者进行了手术治疗,每例均采用个体化治疗方案。

结果

对于女性患者,5例采用背阔肌肌瓣联合硅胶植入物治疗发育不全的乳房。另外2例患者仍在接受组织扩张,以便未来进行肌肉和假体重建。4例仅在患侧使用了假体植入物。为2例患者重建了乳头乳晕复合体。7例女性接受了对侧乳房手术:3例行乳房缩小术,2例行乳房上提术,2例行假体植入术。唯一接受手术的男性采用了内镜下背阔肌肌瓣旋转术进行治疗。

结论

本研究展示了波兰综合征患者的几种乳房重建选择,强调了个体化治疗对于实现完全和充分康复的重要性。

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