Gibney J
Plast Reconstr Surg. 1989 Oct;84(4):607-17; discussion 618-20.
The use of tissue expansion in breast reconstruction is a recognized alternative surgical approach. The second generation of tissue-expanding prostheses is the permanent reverse double-lumen expander. In a series of 100 breast reconstructions using a permanent tissue expander, the clinical benefits of producing a moderate degree of mound ptosis along with observed reduction in pain during expansion are discussed. Additional advantages to the use of the device are the cost savings realized, elimination of a second procedure and a second anesthetic exposure, and a high degree of patient acceptance and satisfaction. This study includes breast reconstruction following mastectomies for malignant and premalignant disease, as demonstrated in 75 delayed and 25 immediate reconstructions, with the longest follow-up being 3 years. Complications of infection (3 percent), significant capsular contracture (4 percent), and implant failure (3 percent) are the most frequent and major complications observed yet. In no instance was breast reconstruction rendered unachievable in the face of these complications. The demonstrated results achieved with permanent tissue-expanding prosthesis, complemented by the obvious benefits and a low rate of significant complications, endorse this method as a viable alternative approach in reconstructive breast surgery.
在乳房重建中使用组织扩张术是一种公认的替代性手术方法。第二代组织扩张假体是永久性反向双腔扩张器。在一系列使用永久性组织扩张器的100例乳房重建手术中，讨论了产生适度程度的乳房下垂以及扩张过程中观察到的疼痛减轻所带来的临床益处。使用该装置的其他优点包括节省成本、避免二次手术和二次麻醉暴露，以及患者的高度接受度和满意度。本研究包括因恶性和癌前疾病行乳房切除术后的乳房重建，75例为延迟重建，25例为即刻重建，最长随访时间为3年。感染（3%）、严重包膜挛缩（4%）和植入物失败（3%）是观察到的最常见和主要的并发症。面对这些并发症，从未出现乳房重建无法实现的情况。永久性组织扩张假体所取得的已证实结果，再加上明显的益处和较低的严重并发症发生率，支持这种方法作为乳房重建手术中一种可行的替代方法。
