Ashitate Yoshitomo, Lee Bernard T, Ngo Long H, Laurence Rita G, Hutteman Merlijn, Oketokoun Rafiou, Lunsford Elaine, Soo Choi Hak, Frangioni John V
Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Ann Plast Surg. 2013 Feb;70(2):149-53. doi: 10.1097/SAP.0b013e31822f9af7.
Preserving the nipple-areolar complex with a nipple-sparing mastectomy improves cosmesis compared with skin-sparing mastectomy. However, complications such as necrosis of the nipple-areolar complex significantly affect cosmetic outcome. Many factors influence nipple-areolar perfusion, and no consensus currently exists on optimal incisional choice. This study evaluates 2 nipple-sparing mastectomy incision models using near-infrared fluorescence to assess perfusion quantitatively. The periareolar and radial incisions were compared with 2 control models in Yorkshire pigs (N = 6). Methylene blue and indocyanine green were injected intravenously, and near-infrared fluorescence images were recorded at 3 time points: before surgery, immediately after (0 hour), and 3 days postoperatively. Contrast-to-background ratio was used to assess perfusion. At 72 hours, radial incisions showed a statistically significantly higher perfusion compared with periareolar incisions (P < 0.05). Based on our findings, radial incisions for nipple-sparing mastectomy may be preferable due to higher perfusion; however, clinical trials are necessary for further assessment.
与保留皮肤的乳房切除术相比，保留乳头乳晕复合体的保乳手术能改善美容效果。然而，乳头乳晕复合体坏死等并发症会显著影响美容效果。许多因素会影响乳头乳晕的血供，目前对于最佳切口选择尚无共识。本研究使用近红外荧光定量评估灌注情况，对两种保留乳头乳晕的乳房切除术切口模型进行了评估。将乳晕周围切口和放射状切口与约克郡猪的两种对照模型（N = 6）进行比较。静脉注射亚甲蓝和吲哚菁绿，并在3个时间点记录近红外荧光图像：手术前、术后即刻（0小时）和术后3天。使用对比背景比来评估灌注情况。在72小时时，放射状切口的灌注情况与乳晕周围切口相比具有统计学显著差异（P < 0.05）。根据我们的研究结果，由于灌注较高，保留乳头乳晕的乳房切除术采用放射状切口可能更可取；然而，还需要进行临床试验以作进一步评估。
