Azzi Alain J, Zammit Dino, Lessard Lucie
Division of Plastic and Reconstructive Surgery, McGill University, Montreal, QC, Canada.
Plast Reconstr Surg Glob Open. 2018 Jan 11;6(1):e1609. doi: 10.1097/GOX.0000000000001609. eCollection 2018 Jan.
When tissue expansion is necessary in breast reconstruction, a single-stage approach is possible using adjustable expander/implants, with or without the use of acellular dermal matrix. We aimed to present the senior author's single-stage experience over a period of 12 years using combined expander/implants in breast reconstruction.
This is a Single-institution, retrospective review of breast reconstruction with combined expander/implants from 2002 to 2014. Logistic regression was performed to evaluate the impact of multiple variables on long-term outcomes.
A total of 162 implants in 105 patients were included in this study. Mean follow-up time was 81.7 months (SD, ± 39.2; range, 15-151). Complication rates were as follows: 0.62% extrusion, 1.2% mastectomy flap necrosis, 1.2% hematoma, 1.9% dehiscence, 2.5% seroma, 4.9% infection, and 15.4% deflation. The following associations were identified by logistic regression: adjuvant radiotherapy and capsular contracture ( = 0.034), tumor size and deflation ( = 0014), and smoking history and infection ( = 0.013).
Overall, 81% of breasts were successfully reconstructed in a single stage. Single-stage reconstruction using all-in-one expander/implants reduces costs by eliminating the need for a second procedure under general anesthesia and can achieve results comparable with other alloplastic reconstructions reported in the literature.
在乳房重建中，当需要组织扩张时，使用可调节扩张器/植入物可采用单阶段方法，可使用或不使用脱细胞真皮基质。我们旨在介绍资深作者在12年期间使用联合扩张器/植入物进行乳房重建的单阶段经验。
这是一项对2002年至2014年间使用联合扩张器/植入物进行乳房重建的单机构回顾性研究。进行逻辑回归以评估多个变量对长期结果的影响。
本研究共纳入105例患者的162个植入物。平均随访时间为81.7个月（标准差，±39.2；范围，15 - 151）。并发症发生率如下：0.62% 植入物挤出、1.2% 乳房切除皮瓣坏死、1.2% 血肿、1.9% 裂开、2.5% 血清肿、4.9% 感染和15.4% 放气。通过逻辑回归确定了以下关联：辅助放疗与包膜挛缩（P = 0.034）、肿瘤大小与放气（P = 0.014）以及吸烟史与感染（P = 0.013）。
总体而言，81% 的乳房成功进行了单阶段重建。使用一体化扩张器/植入物的单阶段重建通过消除在全身麻醉下进行第二次手术的需要降低了成本，并且可以取得与文献中报道的其他异体植入物重建相当的效果。
