Division of Surgery, Saitama Medical Center, 4-9-3 Kitaurawa, Urawa-ku, Saitama city, Saitama, 330-0074, Japan.
Division of Pathology, Saitama Medical Center, Saitama, 330-0074, Japan.
Surg Today. 2020 Sep;50(9):1008-1015. doi: 10.1007/s00595-020-01975-y. Epub 2020 Feb 12.
Periareolar incisions for nipple-sparing mastectomy offer the advantages of smaller inconspicuous wounds and easier resection below the nipple-areolar complex. However, they provide a narrow surgical field, which complicates the procedure and carries a risk of nipple necrosis. This study evaluated the clinical outcomes and safety of periareolar incisions for breast reconstructive surgery in patients with breast cancer.
The study included 181 patients with primary operable breast cancer who underwent nipple-sparing mastectomy for reconstructive breast procedures without intraoperative nipple-areolar complex resection. The clinical outcomes and complications were retrospectively evaluated. The recurrence-free survival was compared using Kaplan-Meier curves.
Nipple-sparing mastectomy was performed via inframammary fold and periareolar incisions in 31 and 150 patients, respectively. There were no significant differences in clinical outcomes related to surgery, frequency of complications, nipple necrosis (inframammary fold incision vs. periareolar incision: 0% vs. 3.3%, P = 0.590), or the recurrence-free survival (P = 0.860) between the 2 groups.
Our results showed that the clinical outcomes and complication rates of periareolar incisions for breast reconstruction were equivalent to those of inframammary fold incisions, suggesting that the periareolar incision technique for breast reconstructive surgery may safely improve cosmetic outcomes if done with adequate care.
乳晕切口行保留乳头的乳房切除术具有切口小、隐蔽、乳晕下复合体切除更容易的优点。然而，它们提供了一个狭窄的手术视野，这使得手术变得复杂，并增加了乳头坏死的风险。本研究评估了乳晕切口在乳腺癌患者乳房重建手术中的临床效果和安全性。
本研究纳入了 181 例原发性可手术乳腺癌患者，这些患者均接受了保留乳头的乳房切除术，用于乳房重建手术，术中未切除乳晕乳头复合体。回顾性评估了临床结果和并发症。采用 Kaplan-Meier 曲线比较无复发生存率。
乳晕切口组和乳晕下皱襞切口组分别有 31 例和 150 例患者接受了保留乳头的乳房切除术。两组手术相关的临床结果、并发症发生率、乳头坏死（乳晕下皱襞切口组与乳晕切口组：0%比 3.3%，P=0.590）或无复发生存率（P=0.860）均无显著差异。
我们的结果表明，乳晕切口行乳房重建的临床效果和并发症发生率与乳晕下皱襞切口相当，这表明如果操作得当，乳晕切口技术可能会安全地改善乳房重建的美容效果。
