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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.

DOI:10.1007/s00266-005-0140-y
PMID:17093886
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。

相似文献

1
Poland's syndrome: different clinical presentations and surgical reconstructions in 18 cases.波兰综合征:18例患者的不同临床表现及手术重建
Aesthetic Plast Surg. 2007 Mar-Apr;31(2):140-6. doi: 10.1007/s00266-005-0140-y.
2
[Breast reconstruction in Poland syndrome. Apropos of 9 cases].
Ann Chir Plast Esthet. 1994 Apr;39(2):211-8; discussion 219-20.
3
[Correction of breast Poland's anomalies. About eight cases and literature review].[波兰氏乳房畸形的矫正。附8例报告及文献复习]
Ann Chir Plast Esthet. 2010 Jun;55(3):211-8. doi: 10.1016/j.anplas.2009.06.003. Epub 2009 Oct 29.
4
Management of the chest-wall deformity in male patients with Poland's syndrome.波兰综合征男性患者胸壁畸形的治疗
Plast Reconstr Surg. 1991 Apr;87(4):674-8; discussion 679-81.
5
Breast construction in Poland's syndrome. Case report.
Handchir Mikrochir Plast Chir. 1983 Sep;15(3):152-3.
6
[A case of so-called Poland's syndrome].
G Chir. 1992 Oct;13(10):467-9.
7
[Congenital breast deformity is a serious handicap. An important indication for breast reconstruction with silicone implants].先天性乳房畸形是一种严重的缺陷。硅胶植入物进行乳房重建的一个重要指征。
Lakartidningen. 1999 Apr 7;96(14):1703-5, 1708-10.
8
Poland syndrome.波兰综合征
Semin Thorac Cardiovasc Surg. 2009 Spring;21(1):89-94. doi: 10.1053/j.semtcvs.2009.03.004.
9
[Poland syndrome--clinical study].[波兰综合征——临床研究]
Akush Ginekol (Sofiia). 2007;46 Suppl 2:16-9.
10
Eight patients with multiple bilateral thoracic anomalies: a new syndrome or bilateral Poland's syndrome?8 例多发双侧胸壁畸形患者:一种新综合征还是双侧波兰氏综合征?
Ann Thorac Surg. 2014 May;97(5):1758-63. doi: 10.1016/j.athoracsur.2014.01.027. Epub 2014 Mar 12.

引用本文的文献

1
Breast Reconstruction with Perforator Flaps in Poland Syndrome: Report of a Two-Stage Strategy and Literature Review.波兰综合征中带穿支皮瓣的乳房重建:两阶段策略报告及文献综述
Breast Care (Basel). 2020 Aug;15(4):421-427. doi: 10.1159/000503848. Epub 2019 Nov 7.
2
Brachysyndactyly in Poland Syndrome.波兰综合征中的短指畸形。
Cureus. 2020 Aug 15;12(8):e9755. doi: 10.7759/cureus.9755.
3
A case report of Poland Syndrome with Absent Limb Anomalies.一例伴有肢体缺如畸形的波兰综合征病例报告。
J Orthop Case Rep. 2019;9(4):3-5. doi: 10.13107/jocr.2019.v09i04.1452.
4
Imaging of congenital chest wall deformities.先天性胸壁畸形的影像学检查
Br J Radiol. 2016;89(1061):20150595. doi: 10.1259/bjr.20150595. Epub 2016 Feb 26.
5
Correction of Poland's Syndrome: Case Report and Review of the Current Literature.波兰氏综合征的矫正:病例报告与文献回顾。
Breast Care (Basel). 2013 May;8(2):139-42. doi: 10.1159/000350778.
6
Poland syndrome: from embryological basis to plastic surgery.波兰综合征:从胚胎学基础到整形手术
Surg Radiol Anat. 2013 Oct;35(8):639-46. doi: 10.1007/s00276-013-1083-7. Epub 2013 Feb 19.
7
Normal Breastfeeding after Breast Reconstruction in a Patient with Poland's Syndrome.波兰综合征患者乳房重建后的正常母乳喂养
Breast Care (Basel). 2011 Dec;6(6):479-481. doi: 10.1159/000335223. Epub 2011 Dec 16.
8
Muscle abnormalities of the chest in Poland's syndrome: variations and proposal for a classification.波兰综合征胸部肌肉异常:变异情况及分类建议
Surg Radiol Anat. 2012 Jan;34(1):57-63. doi: 10.1007/s00276-011-0851-5. Epub 2011 Jul 29.
9
Ectodermal dysplasia with amastia: a case of one-step reconstruction.无乳腺外胚层发育不良:一期重建病例
Case Rep Med. 2009;2009:927354. doi: 10.1155/2009/927354. Epub 2009 May 4.