Serra-Renom José María, Guisantes Eva, Yoon Taisik, Benito-Ruiz Jesus
Department of Plastic Surgery, Hospital Clínico, Barcelona, Spain.
Ann Plast Surg. 2007 Feb;58(2):126-30. doi: 10.1097/01.sap.0000237659.81470.a3.
We present the surgical technique for mammary reconstruction using tissue expander with endoscopic approach, associated to partial detachment of the pectoralis muscle at the fourth rib and complete or nearly complete intraoperative expansion. Tissue expansion for breast reconstruction is a well-honored technique that provides satisfying esthetic outcomes, with minimal morbidity for the patient. Nevertheless, this technique has some potential problems: (1) wound dehiscence with extrusion of the expander; (2) the patient discomfort during the expansion process (weekly visits for the refill of the expander); (3) the poor definition of the lower pole of the breast and cranial migration of the expander with excessive roundness of the upper pole. By using intraoperative tissue expansion, these drawbacks can be avoided. We report herein our experience with this technique in 53 consecutive patients (56 breasts) undergoing a secondary breast reconstruction since December 2001.
我们介绍了使用组织扩张器并采用内镜入路进行乳房重建的手术技术，该技术与在第四肋处部分离断胸大肌以及术中进行完全或近乎完全的扩张相关。乳房重建的组织扩张术是一项备受认可的技术，能提供令人满意的美学效果，对患者的发病率极低。然而，该技术存在一些潜在问题：（1）伤口裂开伴扩张器外露；（2）扩张过程中患者不适（每周需就诊为扩张器注液）；（3）乳房下极形态不佳以及扩张器向上移位导致上极过度圆润。通过术中组织扩张，可以避免这些缺点。本文报告了自2001年12月以来我们对53例（56侧乳房）接受二期乳房重建的患者采用该技术的经验。
