Bertozzi Nicolò, Pesce Marianna, Santi PierLuigi, Raposio Edoardo
Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Cutaneous, Mini-invasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy.
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Plastic Surgery Department, IRCCS San Martino University Hospital, National Institute for Cancer Research, Genoa, Italy.
Ann Med Surg (Lond). 2017 Jul 21;21:34-44. doi: 10.1016/j.amsu.2017.07.048. eCollection 2017 Sep.
In this work, the authors review recent data on the different methods and techniques of TE/implant-based reconstruction to determine the complication profiles and the advantages and disadvantages of the different techniques. This information will be valuable for surgeons performing breast reconstructions.
A thorough literature review was conducted by the authors concerning the current strategy of tissue expander (TE)/implant-based breast reconstruction following breast cancer surgery.
Loss of the breast can strongly affect a woman's personal and social life while breast reconstruction reduces the sense of mutilation felt by women after a mastectomy, and provides psychosocial as well as aesthetic benefits. TE/implant-based reconstruction is the most common breast reconstructive strategy, constituting almost 65% of all breast reconstructions in the US. Although numerous studies have been published on various aspects of alloplastic breast reconstructions, most studies are single-center observations. No evidence-based guidelines are available as yet. Conventional TE/implant-based reconstruction can be performed as a two-stage procedure either in the immediate or delayed setting. Moreover, the adjunctive use of acellular dermal matrix further broadened the alloplastic breast reconstruction indication and also enhanced aesthetic outcomes.
TE/implant-based reconstruction has proved to be a safe, cost-effective, and reliable technique that can be performed in women with various comorbidities. Short operative time, fast recovery, and absence of donor site morbidity are other advantages over autologous breast reconstruction.
在本研究中，作者回顾了近期关于基于组织扩张器（TE）/植入物重建的不同方法和技术的数据，以确定不同技术的并发症情况以及优缺点。这些信息对于进行乳房重建的外科医生具有重要价值。
作者对乳腺癌手术后基于组织扩张器（TE）/植入物的乳房重建的当前策略进行了全面的文献综述。
乳房缺失会严重影响女性的个人和社会生活，而乳房重建可减轻女性乳房切除术后的残缺感，并带来心理和美学上的益处。基于TE/植入物的重建是最常见的乳房重建策略，在美国几乎占所有乳房重建手术的65%。尽管关于异体乳房重建的各个方面已经发表了大量研究，但大多数研究都是单中心观察。目前尚无基于证据的指南。传统的基于TE/植入物的重建可以在即刻或延期情况下分两阶段进行。此外，脱细胞真皮基质的辅助使用进一步拓宽了异体乳房重建的适应症，同时也提高了美学效果。
基于TE/植入物的重建已被证明是一种安全、经济有效且可靠的技术，可用于患有各种合并症的女性。与自体乳房重建相比，手术时间短、恢复快以及无供区并发症也是其其他优点。
