Kamioka Naofumi, Mori Hiroki, Okazaki Mutsumi
6th-year student, Tokyo Medical and Dental University.
J Med Dent Sci. 2010 Mar 1;57(4):203-8.
Some kinds of incisions have been reported in skin- or nipple-sparing mastectomy, but few reports have described the advantages and disadvantages of each incision. This study was conducted to compare the lateral horizontal incision with the lateral vertical incision in both mastectomies, in terms of hypertrophic scarring, breast envelope necrosis, nipple-areola necrosis.
We performed a retrospective analysis of patients who underwent skin- or nipple-sparing mastectomy using lateral horizontal or lateral vertical incisions with immediate breast reconstruction. All data were obtained retrospectively from databases, operation records and postoperative pictures. We compared the frequency of hypertrophic scarring and breast envelope necrosis between lateral horizontal and lateral vertical incision groups by using Pearson's chi-square test. For nipple-sparing mastectomy, we also investigated nipple-areola necrosis.
One hundred fifty cases were analyzed and identified as 89 lateral horizontal incision cases and 61 lateral vertical incision cases. Mastectomy comprised SSM in 49 cases and NSM in 101 cases. Hypertrophic scarring was significantly less frequent with lateral vertical incisions (1.6%) than with lateral horizontal incisions (14.6%) (P =0.007). No significant differences were seen in terms of breast envelope necrosis, nipple-areolar necrosis.
在保乳或保乳头乳房切除术中已报道了几种切口方式，但很少有报告描述每种切口的优缺点。本研究旨在比较保乳或保乳头乳房切除术中横向外侧切口与纵向外侧切口在肥厚性瘢痕形成、乳房包膜坏死、乳头乳晕坏死方面的差异。
我们对采用横向外侧或纵向外侧切口并即刻乳房重建的保乳或保乳头乳房切除术患者进行了回顾性分析。所有数据均从数据库、手术记录和术后图片中回顾性获取。我们使用Pearson卡方检验比较横向外侧切口组和纵向外侧切口组之间肥厚性瘢痕形成和乳房包膜坏死的发生率。对于保乳头乳房切除术，我们还调查了乳头乳晕坏死情况。
共分析了150例病例，其中横向外侧切口89例，纵向外侧切口61例。乳房切除术包括49例皮下乳房切除术和101例保乳头乳房切除术。纵向外侧切口的肥厚性瘢痕形成发生率（1.6%）显著低于横向外侧切口（14.6%）（P = 0.007）。在乳房包膜坏死、乳头乳晕坏死方面未观察到显著差异。
