在需要辅助放疗的患者中，预防性使用己酮可可碱（曲奥舒凡）和维生素E以预防植入物重建后的包膜挛缩。
Prophylactic use of pentoxifylline (Trental) and vitamin E to prevent capsular contracture after implant reconstruction in patients requiring adjuvant radiation.
作者信息
Cook Madeline, Johnson Nathalie, Zegzula Henry Daniel, Schray Mark, Glissmeyer Margaret, Sorenson Leslie
机构信息
Oncology Clinical Research, Legacy Health, Portland, OR, USA.
Legacy Medical Group- Surgical Oncology, NW 1040 22nd Ave, Portland, OR, 97210, USA.
出版信息
Am J Surg. 2016 May;211(5):854-9. doi: 10.1016/j.amjsurg.2016.01.006. Epub 2016 Feb 22.
BACKGROUND
The combination of pentoxifylline (Trental) and vitamin E has been reported to reverse significant consequences of radiation after mastectomy with immediate reconstruction, such as severe capsular contracture or loss of implants. We questioned whether prophylactic use could prevent these consequences.
METHODS
Thirty women with implants or tissue expanders after mastectomy that underwent adjuvant radiation were treated with Trental and vitamin E for 180 days. All subjects then entered a 12-month observational phase.
RESULTS
Of the 26 evaluable subjects, 3 subjects required implant revisions. One due to malposition of the nonradiated breast and 2 were due to contracture (7.7%). There were no implant losses.
CONCLUSIONS
The combination of Trental and vitamin E can prevent severe contracture and implant losses allowing for immediate reconstruction with implant or tissue expander even if radiation is planned after mastectomy.
背景
据报道，己酮可可碱（曲克芦丁）与维生素E联合使用可逆转乳房切除术后即刻重建放疗后的严重后果，如严重的包膜挛缩或植入物丢失。我们质疑预防性使用是否能预防这些后果。
方法
30例乳房切除术后植入假体或组织扩张器并接受辅助放疗的女性患者接受曲克芦丁和维生素E治疗180天。然后所有受试者进入12个月的观察期。
结果
在26例可评估的受试者中，3例需要进行假体修复。1例是由于未接受放疗的乳房位置不当，2例是由于挛缩（7.7%）。没有出现植入物丢失的情况。
结论
曲克芦丁和维生素E联合使用可预防严重挛缩和植入物丢失，即使计划在乳房切除术后进行放疗，也可使用植入物或组织扩张器进行即刻重建。
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