Franceschini Gianluca, Sanchez Alejandro Martin, Visconti Giuseppe, Di Leone Alba, D'Archi Sabatino, Mulè Antonino, Santoro Angela, Salgarello Marzia, Masetti Riccardo
Ann Ital Chir. 2016;87:292-297.
Oncoplastic surgery of the breast has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic procedures (OPP) associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. So, a number of conventional mammoplasty techniques have been adapted to allow reconstruction of resection defects with parenchymal flaps using a variety of different approaches. Thanks to these oncoplastic techniques, the role of breast conserving surgery (BCS) has been extended to include a group of patients who would otherwise require mastectomy to achieve adeguate tumor clearance. However, even with the use of therapeutic mammoplasties, cosmetic outcomes may result unsatisfying when a large volume of parenchyma has to be removed, particularly in medium size breasts and for tumor localized in unfavourable location as central, inner-upper and lower quadrants. Recently, it has been proposed the use of oxidized regenerated cellulose (ORC) as a reconstructive biomaterial to optimize the aesthetic results after OPP. The aim of this article is to describe the standard pattern of an innovative surgical oncoplastic technique with ORC, that we have called "QUORC" (QUadrantectomy with Oxidized Regenerated Cellulose), to improve cosmetic results and minimize the possible postoperative complications after therapeutic mammaplasties.
Breast cancer, Cosmetic results, Oncoplastic surgery, Oxidized regenerated cellulose, QUORC technique.
在过去几年中,乳房肿瘤整形手术引起了极大的关注,并已成为乳腺癌外科治疗的一个组成部分。肿瘤整形手术(OPP)将最佳的外科肿瘤学原则与最佳的整形手术原则相结合,以实现广泛的无瘤切缘并优化美容效果。因此,许多传统的乳房成形术技术已被调整,以允许使用各种不同方法通过实质瓣修复切除缺损。得益于这些肿瘤整形技术,保乳手术(BCS)的作用得以扩展,将一组原本需要乳房切除术以实现充分肿瘤清除的患者纳入其中。然而,即使使用治疗性乳房成形术,当必须切除大量实质组织时,美容效果可能仍不尽人意,特别是对于中等大小乳房以及肿瘤位于中央、内上和下象限等不利位置的情况。最近,有人提议使用氧化再生纤维素(ORC)作为一种重建生物材料,以优化肿瘤整形手术后的美学效果。本文的目的是描述一种创新的肿瘤整形手术技术的标准模式,我们称之为“QUORC”(氧化再生纤维素象限切除术),以改善美容效果并将治疗性乳房成形术后可能的术后并发症降至最低。
乳腺癌;美容效果;肿瘤整形手术;氧化再生纤维素;QUORC技术