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可吸收网片在部分乳房切除术中应用一年以上的随访结果。

Results from over one year of follow-up for absorbable mesh insertion in partial mastectomy.

机构信息

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2011 Sep;52(5):803-8. doi: 10.3349/ymj.2011.52.5.803.

Abstract

PURPOSE

Recently, several clinicians have reported the advantages of simplicity and cosmetic satisfaction of absorbable mesh insertion. However, there is insufficient evidence regarding its long-term outcomes. We have investigated the surgical complications and postoperative examination from the oncologic viewpoint.

MATERIALS AND METHODS

From February 2008 to March 2009, 34 breast cancer patients underwent curative surgery with absorbable mesh insertion in Samsung Medical Center. Patient characteristics and follow up results including complications, clinical and radiological findings were retrospectively investigated.

RESULTS

The mean age of the study population was 50.1±8.9 years old (range 31-82) with a mean tumor size of 3±1.8 cm (range 0.8-10.5), and the excised breast tissue showed a mean volume of 156.1±99.8 mL (range 27-550). Over the median follow-up period of 18±4.6 months (range 3-25), mesh associated complications, including severe pain or discomfort, edema, and recurrent fluid collection, occurred in nine patients (26.5%). In three cases (8.8%), recurrent mastitis resulted in mesh removal or surgical intervention. In the postoperative radiologic survey, the most common finding was fluid collection, which occurred in five patients (16.1%), including one case with organizing hematoma. Fat necrosis and microcalcifications were found in three patients (9.7%).

CONCLUSION

Absorbable mesh insertion has been established as a technically feasible, time-saving procedure after breast excision. However, the follow-up results showed some noticeable side effects and the oncologic safety of the procedure is unconfirmed. Therefore, we suggest that mesh insertion should be considered only in select cases and should be followed-up carefully.

摘要

目的

最近,一些临床医生报告了使用可吸收网片的优势,即操作简单且美容满意度高。然而,关于其长期效果的证据还不够充分。我们从肿瘤学的角度调查了手术并发症和术后检查情况。

材料与方法

2008 年 2 月至 2009 年 3 月,三星医疗中心有 34 名乳腺癌患者接受了可吸收网片置入的根治性手术。回顾性调查了患者特征和随访结果,包括并发症、临床和影像学发现。

结果

研究人群的平均年龄为 50.1±8.9 岁(范围 31-82 岁),平均肿瘤大小为 3±1.8cm(范围 0.8-10.5cm),切除的乳房组织平均体积为 156.1±99.8ml(范围 27-550ml)。在中位随访期 18±4.6 个月(范围 3-25 个月)中,有 9 名患者(26.5%)出现了网片相关并发症,包括严重疼痛或不适、水肿和复发性积液。在 3 例(8.8%)中,复发性乳腺炎导致网片移除或手术干预。术后影像学检查中,最常见的发现是积液,有 5 名患者(16.1%)出现,包括 1 例合并机化性血肿。脂肪坏死和微钙化在 3 例患者(9.7%)中发现。

结论

在乳房切除术后,可吸收网片的置入已被证明是一种可行且省时的技术。然而,随访结果显示出一些明显的副作用,该手术的肿瘤安全性尚未得到证实。因此,我们建议仅在选择的病例中考虑使用网片,并应仔细随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0e/3159934/4160ebd7027b/ymj-52-803-g001.jpg

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