Rassu Pier Carlo
Department of General Surgery, "San Giacomo" Hospital, Via Edilio Raggio, 12, 15067 Novi Ligure, AL, Italy.
Ann Med Surg (Lond). 2015 Dec 22;5:57-66. doi: 10.1016/j.amsu.2015.12.050. eCollection 2016 Feb.
Oxidized regenerated cellulose polymer (ORCP) may be used for reshaping and filling lack of volume in breast-conserving surgery (BCS). The study aimed to observe both the aesthetic and diagnostic outcomes in patients with different age, BMI, breast volume, and breast tissue composition over 36 months after BCS with ORCP.
18 patients with early breast cancer and with proliferative benign lesions underwent BCS with ORCP that was layered in three-dimensional wafer, and placed into the Chassaignac space between the mammary gland and the fascia of pectoralis major with no fixation. After surgery, patients started a clinical and instrumental 36-month follow-up with mammography, ultrasonography, magnetic resonance imaging (MRI) and cytological examination with fine needle aspiration when seroma occurred.
Below the median age of 66 years old no complications were observed even in case both of overweight, and large breasts with low density. Over the median age seromas occurred with either small or large skin retraction, with the exception of 1 patient having quite dense breasts and low BMI, which had no complications. In elderly patients, 1 case with quite dense breasts and high BMI showed severe seroma and skin retraction, while 1 case with low BMI and less dense breasts highlighted milder complications.
During 36 months after BCS with ORCP, a significant correlation between positive diagnostic and aesthetic outcomes and low age, dense breasts, and low BMI of patient was observed. Despite of the few number of cases, either low BMI, or high breast density improved the aesthetic outcomes and reduced the entity of complications even in the elderly patients.
氧化再生纤维素聚合物(ORCP)可用于保乳手术(BCS)中的乳房重塑和填充体积不足。本研究旨在观察接受ORCP保乳手术的不同年龄、体重指数(BMI)、乳房体积和乳房组织构成的患者在36个月后的美学和诊断结果。
18例早期乳腺癌和增生性良性病变患者接受了采用三维薄片分层的ORCP保乳手术,将其置于乳腺与胸大肌筋膜之间的夏塞纳克间隙,未进行固定。术后,患者开始进行为期36个月的临床和仪器随访,包括乳房X线摄影、超声检查、磁共振成像(MRI),以及出现血清肿时进行细针穿刺细胞学检查。
在年龄中位数66岁以下的患者中,即使存在超重和低密度大乳房的情况,也未观察到并发症。在年龄中位数以上的患者中,出现了血清肿,伴有轻度或重度皮肤回缩,但有1例乳房密度相当高且BMI低的患者未出现并发症。在老年患者中,1例乳房密度相当高且BMI高的患者出现了严重血清肿和皮肤回缩,而1例BMI低且乳房密度较低的患者并发症较轻。
在接受ORCP保乳手术的36个月期间,观察到诊断阳性和美学效果与患者年龄小、乳房密度高和BMI低之间存在显著相关性。尽管病例数较少,但低BMI或高乳房密度即使在老年患者中也改善了美学效果并减少了并发症的发生。