Department of Surgery, Division of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Reconstr Microsurg. 2010 Jul;26(5):303-10. doi: 10.1055/s-0030-1249313. Epub 2010 Mar 1.
Studies show some return of breast sensation after breast reconstruction; however, recovery is variable and unpredictable. Efforts are being made to restore innervation by reattaching nerves (neurotization). We sought to systematically review the literature addressing breast sensation after reconstruction. The following databases were searched: EMBASE, Cochrane, and PubMed. Additionally, the PLASTIC AND RECONSTRUCTIVE SURGERY journal was hand searched from 1960 to 2009. Inclusion criteria included breast reconstruction for cancer, return of sensation with objective results, and patients aged 18 to 90 years. Studies with purely cosmetic procedures, case reports, studies with less than 10 patients, and studies involving male patients were excluded. The initial search yielded 109 studies, which was refined to 20 studies with a total pool of 638 patients. Innervated flaps have a greater magnitude of recovery, which occurs at an earlier stage compared with the noninnervated flaps. Overall, sensation to deep inferior epigastric artery perforator flaps may recover better sensation than transverse rectus abdominis myocutaneous flaps, followed by latissimus dorsi flaps, and finally implants. Women's needs and expectations for sensation have led plastic surgeons to investigate ways to facilitate its return. Studies, however, depict conflicting data. Larger series are needed to define the role of neurotization as a modality for improving sensory restoration.
研究表明，乳房重建后会有一些乳房感觉的恢复；然而，恢复情况是可变的且不可预测的。目前正在努力通过重新连接神经（神经再支配）来恢复神经支配。我们旨在系统地回顾关于重建后乳房感觉的文献。搜索了以下数据库：EMBASE、Cochrane 和 PubMed。此外，从 1960 年到 2009 年，还对手册搜索了 PLASTIC AND RECONSTRUCTIVE SURGERY 杂志。纳入标准包括因癌症进行的乳房重建、有客观结果的感觉恢复以及年龄在 18 至 90 岁之间的患者。排除了纯粹的美容手术、病例报告、患者少于 10 例的研究以及涉及男性患者的研究。最初的搜索产生了 109 项研究，经过精炼后得到了 20 项研究，共有 638 例患者。有神经支配的皮瓣恢复程度更大，且发生的时间更早，而无神经支配的皮瓣则恢复程度较小。总的来说，深部腹壁下动脉穿支皮瓣的感觉可能比横行腹直肌肌皮瓣更好地恢复，然后是背阔肌皮瓣，最后是植入物。女性对感觉的需求和期望促使整形外科医生探索促进其恢复的方法。然而，研究描绘了相互矛盾的数据。需要更大的系列来确定神经再支配作为改善感觉恢复的一种方式的作用。
