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["皮肤缩减性乳房切除术"及使用贝克尔35型轮廓乳房植入物进行即刻乳房重建:我们的经验]

["Skin reducing mastectomy" and immediate breast reconstruction with Becker 35 contour profile breast implant: our experience].

作者信息

Chiummariello S, Arleo S, Pataia E, Iera M, Alfano C

机构信息

Struttura Complessa di Chirurgia Plastica e Ricostruttiva, Università di Perugia, Perugia, Italia.

出版信息

Minerva Chir. 2012 Feb;67(1):59-66.

Abstract

AIM

We describe in this paper our experience with the technique of skin-reducing mastectomy in the treatment of breast cancer.

METHODS

Between October 2005 and April 2010 in our Center 33 patients underwent breast surgery utilizing the skin-reducing mastectomy technique and immediate breast reconstruction with expansor/definitive implant Becker 35 contour profile. Contralateral symmetrization was performed in the same operation. All selected patients satisfied inclusion critera either for nipple-sparing mastectomy or prophylactic mastectomy. We selected patients who had large ptosic breasts: areola-submammary fold >8 cm and jugular-nipple distance >25 cm. After histologic exam to confirm the lack of retroareolar tissue infiltration the nipple was preserved in a superior flap.

RESULTS

Twenty-four out of 33 patients (72.7%) did not suffer from complications. In 9 patients (27.3%) we observed early complications. During follow-up we observed in 24 patients (72.7%) Baker I capsular contracture, in 9 patients (27.3%) Baker II capsular contracture. Esthetic results of symmetry, shape and volume were good to optimal. Patients' satisfaction was similar. During the follow up (6-33 months, average 17.7 months) no patient suffered from breast cancer recurrence.

CONCLUSION

The "skin-reducing mastectomy" reduces mutilation and unsightly scar visibility. It gives a pleasant aesthetic outcome without hindering oncological safety.

摘要

目的

本文描述我们在采用皮肤缩减乳房切除术治疗乳腺癌技术方面的经验。

方法

2005年10月至2010年4月期间,我们中心33例患者接受了采用皮肤缩减乳房切除术技术的乳房手术,并使用扩张器/定型植入物贝克尔35轮廓进行即刻乳房重建。在同一手术中进行对侧对称化处理。所有入选患者均符合保乳切除术或预防性乳房切除术的纳入标准。我们选择了乳房下垂严重的患者:乳晕-乳房下皱襞>8厘米且颈-乳头距离>25厘米。在组织学检查确认乳晕后组织无浸润后,乳头保留在上部皮瓣中。

结果

33例患者中有24例(72.7%)未出现并发症。9例患者(27.3%)出现早期并发症。随访期间,我们观察到24例患者(72.7%)出现贝克I级包膜挛缩,9例患者(27.3%)出现贝克II级包膜挛缩。对称、形状和体积的美学效果良好至最佳。患者满意度相似。在随访期间(6 - 33个月,平均17.7个月),无患者出现乳腺癌复发。

结论

“皮肤缩减乳房切除术”减少了毁容和难看疤痕的可见度。它在不影响肿瘤安全性的情况下带来了令人满意的美学效果。

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