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使用氧化再生纤维素进行容积替代的保乳手术:美容效果分析。

Breast conserving surgery using volume replacement with oxidized regenerated cellulose: a cosmetic outcome analysis.

作者信息

Tanaka Satoru, Sato Nayuko, Fujioka Hiroya, Takahashi Yuko, Kimura Kosei, Iwamoto Mitsuhiko, Uchiyama Kazuhisa

出版信息

Breast J. 2014 Mar-Apr;20(2):154-8. doi: 10.1111/tbj.12229.

Abstract

We evaluated the cosmetic outcome of volume replacement with oxidized regenerated cellulose (ORC) after breast-conserving surgery (BCS) and also examined factors that may have influenced the results. Ninety-four patients who underwent BCS with ORC replacement between January 2010 and August 2012 participated in this study. The cosmetic outcomes of these patients were evaluated using scores based on the criteria of the Japan Breast Cancer Society. We evaluated cosmetic scores with regards to several clinical factors and the occurrence of complications after this procedure. The mean score of the cosmetic outcome of all patients was 9.5 points of 12 points. Thirty-seven patients were categorized as “Excellent,” 34 were “Good,” 22 were “Fair,” and 1 was “Poor.” Patient age, body mass index, weight of the specimen, and ORC amount were not significantly different between patients with favorable cosmetic scores and those without. However, the weight of the removed specimen was slightly higher in patients with an unfavorable cosmetic score. Although acute dermatitis and eczema was observed in 15% and 3% of patients, all of them were improved with conservative treatment. Cosmetic scores were significantly higher in patients without complications than in patients with complications. In conclusion, ORC replacement after BCS is a simple and reliable procedure. The selection of indication and prevention of complications are important for obtaining a better cosmetic outcome. This is the first report to cosmetically evaluate a relatively large number of patients that have undergone ORC replacement after BCS.

摘要

我们评估了保乳手术(BCS)后使用氧化再生纤维素(ORC)进行容量替代的美容效果,并研究了可能影响结果的因素。2010年1月至2012年8月间接受BCS并使用ORC替代的94例患者参与了本研究。根据日本乳腺癌学会的标准,使用评分对这些患者的美容效果进行评估。我们评估了与该手术相关的几个临床因素及并发症发生情况的美容评分。所有患者美容效果的平均评分为12分制中的9.5分。37例患者被归类为“优秀”,34例为“良好”,22例为“中等”,1例为“差”。美容评分良好和不佳的患者之间,患者年龄、体重指数、标本重量和ORC用量无显著差异。然而,美容评分不佳的患者切除标本的重量略高。虽然15%的患者出现急性皮炎,3%的患者出现湿疹,但所有患者经保守治疗后均有改善。无并发症患者的美容评分显著高于有并发症的患者。总之,BCS后使用ORC替代是一种简单可靠的手术。选择合适的适应症及预防并发症对于获得更好的美容效果很重要。这是首篇对相对大量BCS后接受ORC替代的患者进行美容评估的报告。

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