Kijima Yuko, Koriyama Chihaya, Fujii Teruhiko, Hirokaga Kouichi, Ishigure Kiyoshi, Kaneko Tomoyo, Kayano Shuji, Miyamoto Sachio, Sagara Yasuaki, Sakurai Takashi, Sakurai Teruhisa, Sotome Keiichi, Ueo Hiroaki, Wakita Kazuyuki, Watatani Masahiro
1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan.
Gland Surg. 2015 Apr;4(2):179-94. doi: 10.3978/j.issn.2227-684X.2015.01.06.
Immediate volume replacement using a free dermal fat graft (FDFG) has been proven safe with early postoperative benefits. The aims of the present study were to clarify adequate indications and risk factors associated with operative morbidity.
A multi-institutional analysis of partial mastectomy with immediate volume replacement with FDFG was undertaken in 14 hospitals specializing in breast cancer treatment. Clinical and oncological variables were analyzed to identify factors associated with postoperative complications.
A total of 262 cases were analyzed. Considering the observation period and overlap of patients, 13 (5.4%) out of 242 patients had complications within 1 month of surgery while 7 (4.6%) out of 151 patients developed complications 1-12 months after surgery. Two hundred and eleven out of 242 patients were statistically examined using a multivariate analysis, which revealed that the weight of resected breast tissue, size of implanted FDFG (cranio-caudal length), and weight of implanted FDFG were associated with a higher likelihood of postoperative complications.
Immediate breast volume replacement using a FDFG after breast cancer surgery should be done for selected patients with breast cancer to avoid postoperative complications. The prospective and larger investigations are warranted for the establishment of appropriate guidelines.
使用游离真皮脂肪移植（FDFG）进行即刻容量替代已被证明是安全的，且术后早期有益。本研究的目的是明确合适的适应症以及与手术发病率相关的危险因素。
在14家专门治疗乳腺癌的医院对采用FDFG进行即刻容量替代的保乳手术进行了多机构分析。对临床和肿瘤学变量进行分析，以确定与术后并发症相关的因素。
共分析了262例病例。考虑到观察期和患者重叠情况，242例患者中有13例（5.4%）在术后1个月内出现并发症，151例患者中有7例（4.6%）在术后1 - 12个月出现并发症。对242例患者中的211例进行了多因素分析，结果显示切除的乳腺组织重量、植入的FDFG大小（头尾长度）以及植入的FDFG重量与术后并发症的发生可能性较高相关。
乳腺癌手术后使用FDFG进行即刻乳房容量替代应针对选定的乳腺癌患者进行，以避免术后并发症。为制定适当的指南，有必要进行前瞻性的更大规模研究。
