Mesbahi Ali N, McCarthy Colleen M, Disa Joseph J
Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan-Kettering Cancer Center, New York 10021, USA.
Cancer J. 2008 Jul-Aug;14(4):230-5. doi: 10.1097/PPO.0b013e31817fb7c3.
For patients who undergo mastectomy for the treatment of breast cancer, the restoration of a normal breast form through breast reconstruction is important to body image and quality of life. Implant-based reconstruction has the capability of producing excellent results in the well selected patient. In addition, compared with autogenous tissue reconstruction, implant reconstruction offers a shorter operative procedure with a quicker convalescence and no donor site morbidity. Reconstruction options for implant-based reconstruction include: single-stage reconstruction with a standard or adjustable implant, tissue expansion followed by placement of a permanent implant, or combined autologous tissue/implant reconstruction. Procedure selection is based on a range of patient variables, including: location and type of breast cancer, availability of local, regional and distant donor tissue, size and shape of the desired breast(s), surgical risk, and most importantly, patient preference. Although satisfactory results can be obtained with single-stage reconstruction, in most of patients, a more reliable approach involves two-stage expander/implant reconstruction. Individualizing selection of a reconstructive technique for each patient will be the predominant factor in achieving a reconstructive success.
对于因乳腺癌接受乳房切除术的患者，通过乳房重建恢复正常乳房形态对身体形象和生活质量至关重要。对于精心挑选的患者，基于植入物的重建能够产生优异的效果。此外，与自体组织重建相比，植入物重建手术过程更短，恢复更快，且无供区并发症。基于植入物的重建的选择包括：使用标准或可调节植入物的一期重建、组织扩张后植入永久性植入物，或自体组织/植入物联合重建。手术方式的选择基于一系列患者变量，包括：乳腺癌的位置和类型、局部、区域和远处供区组织的可用性、期望乳房的大小和形状、手术风险，以及最重要的患者偏好。虽然一期重建可获得满意的效果，但在大多数患者中，更可靠的方法是两期扩张器/植入物重建。针对每位患者个性化选择重建技术将是实现重建成功的主要因素。
