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同一患者即刻乳房重建中生物补片和合成补片的第一年并发症:一项随机对照研究。

First-year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study.

机构信息

Department of Plastic Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.

Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

J Surg Oncol. 2021 Jan;123(1):80-88. doi: 10.1002/jso.26227. Epub 2020 Oct 13.

Abstract

BACKGROUND

Even though meshes and matrices are widely used in breast reconstruction, there is little high-quality scientific evidence for their risks and benefits. The aim of this study was to compare first-year surgical complication rates in implant-based immediate breast reconstruction with a biological mesh with that of a synthetic mesh, in the same patient.

METHODS

This study is a clinical, randomized, prospective trial. Patients operated on with bilateral mastectomy and immediate breast reconstruction were randomized to biological mesh on one side and synthetic mesh on the other side.

RESULTS

A total of 48 breasts were randomized. As the synthetically and the biologically reconstructed breasts that were compared belonged to the same woman, systemic factors were exactly the same in the two groups. The most common complication was seroma formation with a frequency of 38% in the biological group and 3.8% in the synthetical group (p = .011). A higher frequency of total implant loss could be seen in the biologic mesh group (8.5% vs. 2%), albeit not statistically significant (p = .083).

CONCLUSIONS

In the same patient, a synthetic mesh seems to yield a lower risk for serious complications, such as implant loss, than a biological mesh.

摘要

背景

尽管网片和基质在乳房重建中被广泛应用,但对于其风险和益处的高质量科学证据却很少。本研究的目的是比较同种患者中即刻乳房重建中使用生物补片与合成补片的第一年手术并发症发生率。

方法

这是一项临床、随机、前瞻性试验。接受双侧乳房切除术和即刻乳房重建的患者被随机分为一侧使用生物补片,另一侧使用合成补片。

结果

共 48 例乳房被随机分组。由于比较的合成和生物重建的乳房属于同一女性,两组的系统性因素完全相同。最常见的并发症是血清肿形成,生物组的发生率为 38%,合成组的发生率为 3.8%(p=0.011)。生物补片组总假体失效率较高(8.5%比 2%),但无统计学意义(p=0.083)。

结论

在同种患者中,与生物补片相比,合成补片似乎可降低严重并发症(如假体丢失)的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a33/7821308/c547524f4356/JSO-123-80-g001.jpg

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