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保乳乳房切除术后采用腹壁下深动脉穿支皮瓣进行一期乳头和乳房重建。

One-stage nipple and breast reconstruction using a deep inferior epigastric perforator flap after a skin-sparing mastectomy.

作者信息

Cho Hyun Jun, Kwon Hyo Jeong, Moon Suk-Ho, Jun Young Joon, Rhie Jong Won, Oh Deuk Young

机构信息

Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Arch Plast Surg. 2020 Jan;47(1):26-32. doi: 10.5999/aps.2019.00598. Epub 2020 Jan 15.

Abstract

BACKGROUND

Nipple reconstruction is usually performed as a delayed procedure in patients with breast cancer who undergo skin-sparing mastectomy and breast reconstruction surgery using a deep inferior epigastric perforator (DIEP) flap. The authors designed this study to evaluate the utility of breast reconstruction based on a DIEP flap and immediate nipple reconstruction.

METHODS

A retrospective review was conducted of all patients who underwent breast reconstruction performed by a single plastic surgeon from October 2016 to June 2018. Through a questionnaire and chart review, we compared surgical.

RESULTS

and complications in cases of single-stage nipple reconstruction after skin-sparing mastectomy (n=17) with patients who underwent delayed nipple reconstruction after skin-sparing mastectomy, modified radical mastectomy, or simple mastectomy (n=7).

RESULTS

In a subjective analysis using clinical photos, the immediate nipple reconstruction group had higher scores than their counterparts in an evaluation of the nipple-areolar complex (NAC) (NAC placement, 3.34 vs. 3.04; nipple projection, 3.05 vs. 3.03; nipple size, 3.30 vs. 3.29). No significant differences between the groups were found in terms of complications.

CONCLUSIONS

Simultaneous nipple reconstruction is a reliable surgical method with economic advantages. No differences were found in terms of outcomes and complications in comparison to delayed reconstruction. Therefore, surgeons can consider simultaneous nipple reconstruction without particular concerns about asymmetry or necrosis.

摘要

背景

对于接受保留皮肤的乳房切除术并使用腹壁下深动脉穿支(DIEP)皮瓣进行乳房重建手术的乳腺癌患者,乳头重建通常作为一种延迟手术进行。作者设计本研究以评估基于DIEP皮瓣的乳房重建及即刻乳头重建的效用。

方法

对2016年10月至2018年6月由单一整形外科医生进行乳房重建的所有患者进行回顾性研究。通过问卷调查和病历审查,我们比较了保留皮肤的乳房切除术后单阶段乳头重建病例(n = 17)与保留皮肤的乳房切除术后、改良根治性乳房切除术后或单纯乳房切除术后进行延迟乳头重建的患者(n = 7)的手术情况及并发症。

结果

在使用临床照片进行的主观分析中,即刻乳头重建组在乳头乳晕复合体(NAC)评估中的得分高于对照组(NAC位置,3.34对3.04;乳头突出度,3.05对3.03;乳头大小,3.30对3.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26e2/6976742/dd286b1cd200/aps-2019-00598f1.jpg

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