乳房切除术后放射治疗与乳房重建：并发症及患者满意度分析
Postmastectomy radiation therapy and breast reconstruction: an analysis of complications and patient satisfaction.
作者信息
Lee Bernard T, A Adesiyun Tolulope, Colakoglu Salih, Curtis Michael S, Yueh Janet H, E Anderson Katarina, Tobias Adam M, Recht Abram
机构信息
Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
出版信息
Ann Plast Surg. 2010 May;64(5):679-83. doi: 10.1097/SAP.0b013e3181db7585.
The indications for postmastectomy radiotherapy (PMRT) have expanded over the past decade. This study examines PMRT and reconstruction compared with a control group without radiotherapy. There were 919 reconstructed breasts identified (1999-2006) and separated into 3 groups: mastectomy with PMRT before reconstruction (n = 57), immediate reconstruction then PMRT (n = 59), and reconstruction without PMRT (n = 665). A validated questionnaire assessed patient satisfaction (response rate 73.7%). Overall complication rates for patients undergoing PMRT (before and after reconstruction) were higher than that of the controls (39.66% vs. 23.16%, P < 0.001). Immediate reconstruction before PMRT had increased overall and late (>90 days) complication rates, compared with controls (47.46% vs. 23.16%, P < 0.001; 33.90% vs. 15.59%, P < 0.001, respectively); however general and aesthetic satisfaction was similar. In contrast, PMRT before reconstruction has similar complication rates and general satisfaction with controls, but decreased aesthetic satisfaction (50% vs. 66.88%, P < 0.035).
在过去十年中，乳房切除术后放疗（PMRT）的适应证有所扩展。本研究将PMRT联合乳房重建与未接受放疗的对照组进行了比较。共识别出919例乳房重建病例（1999 - 2006年），并分为3组：重建前接受PMRT的乳房切除术组（n = 57）、即刻重建后接受PMRT组（n = 59）以及未接受PMRT的重建组（n = 665）。通过一份经过验证的问卷评估患者满意度（回复率73.7%）。接受PMRT（重建前后）患者的总体并发症发生率高于对照组（39.66%对23.16%，P < 0.001）。与对照组相比，PMRT前即刻重建的总体和晚期（>90天）并发症发生率均有所增加（分别为47.46%对23.16%，P < 0.001；33.90%对15.59%，P < 0.001）；然而，总体满意度和美学满意度相似。相比之下，重建前接受PMRT的并发症发生率和总体满意度与对照组相似，但美学满意度降低（50%对66.88%，P < 0.035）。
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