Cahan Anthony C, Palaia David A, Rosenberg Michael, Bonanno Philip C
Breast Surgery Division, The Breast Institute at Northern Westchester Hospital, Mt. Kisco, NY, USA.
Ann Plast Surg. 2011 May;66(5):424-8. doi: 10.1097/SAP.0b013e318214566b.
The Box-To-X incision and closure is a novel technique for a skin-sparing mastectomy with immediate prosthetic reconstruction. The Box-To-X portal creates a 27% larger access for dissection as compared with a standard periareolar incision, while containing the entire scar within the limits of the original areola. Following nipple-areolar reconstruction and tattooing, a virtually scarless mastectomy results. Over a 54-month period, 159 skin-sparing mastectomies with immediate prosthetic reconstruction using the Box-To-X portal were performed on 98 patients. Allograft slings were used in all patients. Successful reconstruction was achieved in 93 of 98 patients (93%). Complications were observed in 23 (23%) patients. The most common complications were wound dehiscence, seroma, full-thickness necrosis along the edges of the "X," and wound infection. Removal of the implant was required in 5 patients as a result of persistent infection (5%). The low complication rate, adherence to accepted oncologic principles, and minimal scarring indicate that this technique is a sound addition to the armamentarium of both the breast oncologic surgeon and the reconstructive surgeon.
“盒形至X形”切口与缝合是一种用于保留皮肤的乳房切除术并即刻进行假体再造的新技术。与标准乳晕周围切口相比，“盒形至X形”入路为解剖提供了大27%的操作空间，同时将整个瘢痕限制在原乳晕范围内。在乳头乳晕再造和纹身之后，可实现几乎无痕的乳房切除术。在54个月的时间里，对98例患者进行了159例使用“盒形至X形”入路的保留皮肤乳房切除术并即刻进行假体再造。所有患者均使用了同种异体移植吊带。98例患者中有93例（93%）成功完成再造。23例（23%）患者出现并发症。最常见的并发症是伤口裂开、血清肿、“X”形边缘的全层坏死和伤口感染。5例（5%）患者因持续感染需要取出植入物。低并发症发生率、符合公认的肿瘤学原则以及最小的瘢痕表明，该技术是乳腺肿瘤外科医生和重建外科医生手术手段中的一项可靠补充。
