Kim Jeong-Hoon, Park Jin-Woo, Woo Kyong-Je
Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea.
Medicina (Kaunas). 2020 Sep 24;56(10):498. doi: 10.3390/medicina56100498.
There is no consensus regarding accurate methods for assessing the size of the implant required for achieving symmetry in direct-to-implant (DTI) breast reconstruction. The purpose of this study was to determine whether the ideal implant size could be estimated using 3D breast volume or mastectomy specimen weight, and to compare prediction performances between the two variables. : Patients who underwent immediate DTI breast reconstruction from August 2017 to April 2020 were included in this study. Breast volumes were measured using 3D surface imaging preoperatively and at postoperative three months. Ideal implant size was calculated by correcting the used implant volume by the observed postoperative asymmetry in 3D surface imaging. Prediction models using mastectomy weight or 3D volume were made to predict the ideal implant volume. The prediction performance was compared between the models. : A total of 56 patients were included in the analysis. In correlation analysis, the volume of the implant used was significantly correlated with the mastectomy specimen weight (R2 = 0.810) and the healthy breast volume (R2 = 0.880). The mean ideal implant volume was 278 ± 123 cc. The prediction model was developed using the healthy breast volume: Implant volume (cc) = healthy breast volume × 0.78 + 26 cc (R2 = 0.900). The prediction model for the ideal implant size using the 3D volume showed better prediction performance than that of using the mastectomy specimen weight (R2 = 0.900 vs 0.759, < 0.001). : The 3D volume of the healthy breast is a more reliable predictor than mastectomy specimen weight to estimate the ideal implant size. The estimation formula obtained in this study may assist in the selection of the ideal implant size in unilateral DTI breast reconstruction.
对于评估直接植入式（DTI）乳房重建中实现对称所需植入物大小的准确方法，目前尚无共识。本研究的目的是确定是否可以使用三维乳房体积或乳房切除标本重量来估计理想的植入物大小，并比较这两个变量之间的预测性能。：本研究纳入了2017年8月至2020年4月期间接受即刻DTI乳房重建的患者。术前及术后三个月使用三维表面成像测量乳房体积。通过三维表面成像中观察到的术后不对称情况对使用的植入物体积进行校正，从而计算出理想的植入物大小。建立了使用乳房切除重量或三维体积的预测模型来预测理想的植入物体积。比较了各模型之间的预测性能。：共有56例患者纳入分析。在相关性分析中，使用的植入物体积与乳房切除标本重量（R2 = 0.810）和健侧乳房体积（R2 = 0.880）显著相关。理想植入物的平均体积为278 ± 123 cc。使用健侧乳房体积建立了预测模型：植入物体积（cc）=健侧乳房体积×0.78 + 26 cc（R2 = 0.900）。使用三维体积预测理想植入物大小的模型比使用乳房切除标本重量的模型具有更好的预测性能（R2 = 0.900对0.759，<0.001）。：健侧乳房的三维体积比乳房切除标本重量更可靠地预测理想的植入物大小。本研究中获得的估计公式可能有助于在单侧DTI乳房重建中选择理想的植入物大小。
