Wood Benjamin C, Levine Edward A, Marks Malcolm W, David Lisa R
Department of Plastic and Reconstructive Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Ann Plast Surg. 2011 May;66(5):564-7. doi: 10.1097/SAP.0b013e31820b406c.
The ability to more definitively plan breast reconstruction after obtaining final histologic analysis of the sentinel lymph node biopsy (SLNB) has led several groups to advocate a staged approach to SLNB and mastectomy. Certain disadvantages are inherent in that approach, including increased patient morbidity, financial expense, and inconvenience. A retrospective review was conducted 195 procedures in which mastectomy and SLNB were performed in a single stage with immediate breast reconstruction (IBR) over a 10-year period. Long-term outcomes were analyzed within the context of patient characteristics and SLNB results. Intraoperative SLNB analysis was found to be a reliable method for planning IBR, as there were no patients noted to have untoward sequelae as a result of a false-negative SLNB, and the probability of postmastectomy radiation therapy was predictable based on the intraoperative SLNB results. We advocate that SLNB be performed in a single stage with mastectomy and IBR.
在获得前哨淋巴结活检（SLNB）的最终组织学分析结果后，能够更确切地规划乳房重建，这使得一些研究团队主张采用分期进行SLNB和乳房切除术的方法。该方法存在一些固有的缺点，包括患者发病率增加、经济费用以及不便之处。我们对195例手术进行了回顾性研究，这些手术在10年期间内将乳房切除术和SLNB与即刻乳房重建（IBR）在同一阶段进行。在患者特征和SLNB结果的背景下分析了长期结果。术中SLNB分析被发现是规划IBR的可靠方法，因为没有患者因SLNB假阴性而出现不良后果，并且基于术中SLNB结果，乳房切除术后放疗的概率是可预测的。我们主张将SLNB与乳房切除术和IBR在同一阶段进行。
