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患者报告的结果和美容评估,使用钛化聚丙烯网(TiLOOP® Bra)进行基于植入物的乳房重建:269 例患者的前瞻性临床研究。

Patient reported outcome and cosmetic evaluation following implant-based breast-reconstruction with a titanized polypropylene mesh (TiLOOP® Bra): A prospective clinical study in 269 patients.

机构信息

Department of Gynecology and Gynecologic Oncology, Agaplesion Markus Hospital, Frankfurt Am Main, Germany.

Center for Breast Diseases, Vivantes Hospital Am Urban, Berlin, Germany.

出版信息

Eur J Surg Oncol. 2020 Aug;46(8):1484-1490. doi: 10.1016/j.ejso.2020.04.009. Epub 2020 Apr 15.

Abstract

INTRODUCTION

Implant-based or expander-supported breast reconstruction is an established surgical method after mastectomies due to cancer or to prophylactic reasons. Patient reported outcome (PRO) and cosmetic outcome after breast reconstruction with a synthetic surgical mesh was investigated in a prospective, single-arm, multi-center study.

MATERIAL AND METHODS

Primary or secondary implant-based breast reconstruction with support of TiLOOP® Bra was performed in 269 patients during the PRO-BRA study. PRO 12 months after breast reconstruction was evaluated using Breast-Q questionnaire. Cosmetic outcome was evaluated by two independent experts by means of pictures taken preoperatively and at the follow-up visits.

RESULTS

Breast-Q and 12 months FU were completed by 210 women. Patients without adverse event had a significantly higher Breast-Q score for "sexual well-being" (p = 0.001); "psychosocial well-being" was negatively influenced by prior therapies (p < 0.01), and older patients had significantly lower scores at 12 months FU compared to pre-OP for "satisfaction with breasts" (p < 0.01) while the opposite was true for younger patients. Unilateral surgery resulted in reduced "satisfaction with breast" at 12 months FU (p < 0.01). Radiotherapy negatively influenced "satisfaction with breast", "sexual well-being" and "physical well-being chest". The cosmetic evaluation showed a significant difference (p < 0.001) in the evaluation by the patients and experts with the patients' assessment being worse compared to experts' assessment.

CONCLUSION

Our study showed that two years after implant-based breast reconstruction with support of TiLOOP® Bra PRO is influenced by different factors. This information can be used to improve the decision-making process for women who chose implant-based breast reconstruction.

摘要

简介

基于植入物或扩张器支持的乳房重建是一种在因癌症或预防性原因而进行乳房切除术之后建立的外科方法。在一项前瞻性、单臂、多中心研究中,研究了使用合成外科网片进行乳房重建后的患者报告结局(PRO)和美容结局。

材料和方法

在 PRO-BRA 研究中,269 例患者接受了原发性或继发性基于植入物的乳房重建,使用 TiLOOP® Bra 进行支持。乳房重建 12 个月后的 PRO 使用乳房质量问卷(Breast-Q)进行评估。通过术前和随访时拍摄的照片,由两名独立专家评估美容结局。

结果

210 名女性完成了乳房质量问卷和 12 个月的随访。无不良事件的患者在“性健康”方面的乳房质量问卷评分显著更高(p=0.001);先前的治疗对“心理社会健康”有负面影响(p<0.01),且老年患者在 12 个月随访时的“对乳房的满意度”评分显著低于术前(p<0.01),而年轻患者则相反。单侧手术导致 12 个月随访时的“对乳房的满意度”降低(p<0.01)。放射治疗对“对乳房的满意度”、“性健康”和“胸部的生理健康”有负面影响。美容评估显示,患者和专家的评估存在显著差异(p<0.001),患者的评估比专家的评估更差。

结论

我们的研究表明,在接受 TiLOOP® Bra 支持的基于植入物的乳房重建两年后,PRO 受到多种因素的影响。这些信息可以用于改善选择基于植入物的乳房重建的女性的决策过程。

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