Ng E-Ern Ian, Quah Gaik Si, Graham Susannah, Kanesalingam Kavitha, Meybodi Farid, Hsu Jeremy, Elder Elisabeth E, French James
Westmead Breast Cancer Institute, Westmead Hospital, Sydney, New South Wales, Australia.
Discipline of Surgery, Sydney Medical School, Sydney, New South Wales, Australia.
ANZ J Surg. 2021 Apr;91(4):701-707. doi: 10.1111/ans.16670. Epub 2021 Feb 26.
Implant-based reconstruction accounts for the majority of breast reconstructive procedures performed in Australia. More recently, immediate prepectoral implant reconstruction using the TiLOOP Bra Pocket has gained popularity. This study compares post-surgical complications and patient-reported quality of life outcomes between immediate prepectoral and dual plane implant reconstruction.
A retrospective study of 80 consecutive patients who underwent nipple-sparing mastectomies and immediate implant reconstruction was conducted. Implants were either completely covered with TiLOOP Bra and/or TiLOOP Bra Pocket (pfm medical, Cologne, Germany) and secured in the prepectoral space (prepectoral group) or placed in the subpectoral plane with inferolateral mesh coverage (dual plane group). Data surrounding patient demographics, clinical details and post-surgical outcomes were compared. Patient-related quality of life outcomes were assessed with the Breast-Q questionnaire.
A total of 80 patients (109 breasts) operated on between June 2016 and December 2018 were included. The prepectoral and dual plane groups comprised of 40 patients each, including 50 and 59 operated breasts, respectively. Post-operative complications were comparable with 11 (22%) overall complications in the prepectoral group and eight (14%) in the dual plane group (P = 0.313). Implant loss was uncommon with four (8%) cases in the prepectoral group and five (8.5%) in the dual plane group (P = 0.929). Patient-reported quality of life outcomes were superior after prepectoral reconstruction with patients reporting a significantly higher score in the satisfaction with breasts domain (68.9 versus 57.5; P = 0.036).
Immediate prepectoral implant reconstruction with the TiLOOP Bra Pocket was associated with improved patient satisfaction and demonstrated no difference in early post-operative outcomes.
在澳大利亚，基于植入物的乳房重建手术占大多数。最近，使用TiLOOP胸罩口袋进行即刻胸前植入物重建越来越受欢迎。本研究比较了即刻胸前和双平面植入物重建术后的并发症及患者报告的生活质量结果。
对80例连续接受保乳全乳房切除术和即刻植入物重建的患者进行回顾性研究。植入物用TiLOOP胸罩和/或TiLOOP胸罩口袋（pfm medical，德国科隆）完全覆盖，并固定在胸前间隙（胸前组），或置于胸大肌下平面并覆盖下外侧网片（双平面组）。比较患者人口统计学、临床细节和术后结果等数据。使用乳房Q问卷评估患者相关的生活质量结果。
纳入了2016年6月至2018年12月期间手术的80例患者（109个乳房）。胸前组和双平面组各有40例患者，分别包括50个和59个手术乳房。术后并发症相当，胸前组总体并发症为11例（22%），双平面组为8例（14%）（P = 0.313）。植入物丢失不常见，胸前组有4例（8%），双平面组有5例（8.5%）（P = 0.929）。胸前重建术后患者报告的生活质量结果更好，患者在乳房满意度方面的得分显著更高（68.9对57.5；P = 0.036）。
使用TiLOOP胸罩口袋进行即刻胸前植入物重建可提高患者满意度，且早期术后结果无差异。
