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使用手术显微镜和牵引技术对输乳管进行选择性解剖的乳头内陷矫正术

Inverted Nipple Correction with Selective Dissection of Lactiferous Ducts Using an Operative Microscope and a Traction Technique.

作者信息

Sowa Yoshihiro, Itsukage Sizu, Morita Daiki, Numajiri Toshiaki

机构信息

Departments of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.

出版信息

Aesthetic Plast Surg. 2017 Oct;41(5):1045-1048. doi: 10.1007/s00266-017-0874-3. Epub 2017 Apr 13.

Abstract

BACKGROUND

An inverted nipple is a common congenital condition in young women that may cause breastfeeding difficulty, psychological distress, repeated inflammation, and loss of sensation. Various surgical techniques have been reported for correction of inverted nipples, and all have advantages and disadvantages. Here, we report a new technique for correction of an inverted nipple using an operative microscope and traction that results in low recurrence and preserves lactation function and sensation.

METHODS

Between January 2010 and January 2013, we treated eight inverted nipples in seven patients with selective lactiferous duct dissection using an operative microscope. An opposite Z-plasty was added at the junction of the nipple and areola. Postoperatively, traction was applied through an apparatus made from a rubber gasket attached to a sterile syringe. Patients were followed up for 15-48 months.

RESULTS

Adequate projection was achieved in all patients, and there was no wound dehiscence or complications such as infection. Three patients had successful pregnancies and subsequent breastfeeding that was not adversely affected by the treatment. There was no loss of sensation in any patient during the postoperative period.

CONCLUSION

Our technique for treating an inverted nipple is effective and preserves lactation function and nipple sensation. The method maintains traction for a longer period, which we believe increases the success rate of the surgery for correction of severely inverted nipples.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

乳头内陷是年轻女性常见的先天性疾病,可能导致母乳喂养困难、心理困扰、反复炎症和感觉丧失。已有多种手术技术用于矫正乳头内陷,各有优缺点。在此,我们报告一种使用手术显微镜和牵引矫正乳头内陷的新技术,该技术复发率低,能保留泌乳功能和感觉。

方法

2010年1月至2013年1月,我们使用手术显微镜对7例患者的8个乳头内陷进行了选择性乳腺导管解剖治疗。在乳头和乳晕交界处加做一个反向Z成形术。术后,通过由连接无菌注射器的橡胶垫圈制成的装置进行牵引。对患者进行了15 - 48个月的随访。

结果

所有患者均获得了足够的乳头突出,无伤口裂开或感染等并发症。3例患者成功怀孕并随后进行母乳喂养且未受到治疗的不利影响。术后所有患者均无感觉丧失。

结论

我们治疗乳头内陷的技术有效,能保留泌乳功能和乳头感觉。该方法能长时间维持牵引,我们认为这提高了严重乳头内陷矫正手术的成功率。

证据等级IV:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266

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