Kellou K, Lequesne J, Georgescu D, De Gournay E, Bréard H, Carrilho J, Forestier F, Poteau A, Crouzet A
Département de chirurgie, centre régional de lutte contre le cancer de Rouen, 76000 Rouen, France.
Unité de recherche clinique, centre régional de lutte contre le cancer de Rouen, 76000 Rouen, France.
Gynecol Obstet Fertil Senol. 2019 Apr;47(4):347-351. doi: 10.1016/j.gofs.2019.02.007. Epub 2019 Feb 19.
The primary objective was to assess the failure rate of exclusive lipofilling breast reconstruction. The secondary objectives were the identification of failure predictive factors of exclusive lipofilling breast reconstruction and the early complications.
We performed a retrospective study in Normandy analysing cases of secondary breast reconstruction by exclusive lipofilling after radical mastectomy, from January 2006 to December 2016. We compared a group of patients who completed exclusive lipofilling breast reconstruction (n=22) with a group of patients who underwent other techniques of breast reconstruction (n=16).
The failure rate of breast reconstruction by exclusive lipofilling was 32.6%. Need of adjuvant chemotherapy treatment was associated with a higher failure rate than exclusive lipofilling breast reconstruction (81.2% vs. 45.5%, P<0.05). The age of patients was significantly higher in case of reconstruction failure (45.2 vs. 50.9 years mean age, P<0.05). Need of adjuvant radiotherapy treatment was not associated with a higher failure rate than exclusive lipofilling breast reconstruction. The main complications were cutaneous burn due to cannula and haematoma at the donor site (11/22) and breast haematoma (11/22).
Informing patients of the risk of breast reconstruction failure due to the high adipocytes resorption, is necessary when patients are undergoing exclusive lipofilling breast reconstruction. A prospective study with greater workforce is needed to shore these results and assess postoperative complications.
主要目的是评估单纯脂肪填充乳房重建的失败率。次要目的是确定单纯脂肪填充乳房重建失败的预测因素以及早期并发症。
我们在诺曼底进行了一项回顾性研究，分析了2006年1月至2016年12月根治性乳房切除术后单纯脂肪填充进行二期乳房重建的病例。我们将一组完成单纯脂肪填充乳房重建的患者（n = 22）与一组接受其他乳房重建技术的患者（n = 16）进行了比较。
单纯脂肪填充乳房重建的失败率为32.6%。需要辅助化疗的患者的失败率高于单纯脂肪填充乳房重建（81.2%对45.5%，P < 0.05）。重建失败患者的年龄显著更高（平均年龄45.2岁对50.9岁，P < 0.05）。需要辅助放疗与高于单纯脂肪填充乳房重建的失败率无关。主要并发症是插管引起的皮肤烧伤和供区血肿（11/22）以及乳房血肿（11/22）。
当患者接受单纯脂肪填充乳房重建时，有必要告知患者由于脂肪细胞吸收率高导致乳房重建失败的风险。需要进行一项有更多人力参与的前瞻性研究来支持这些结果并评估术后并发症。
