Department of Surgical Oncology, Paoli Calmettes Institute and Centre de Recherche en Cancerérologie de Marseille (CRCM), Aix-Marseille University, Marseille, France.
Department of Surgical Oncology, Paoli Calmettes Institute, Marseille, France.
Br J Surg. 2021 Apr 5;108(3):296-301. doi: 10.1093/bjs/znaa082.
Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is used increasingly when performing a prophylactic mastectomy. Few prospective studies have reported on complication rates. This complementary trial to the French prospective multicentre MAPAM trial aimed to evaluate the nipple-areola complex (NAC) necrosis rate in prophylactic NSM with IBR.
Patient characteristics and surgical data were recorded. Morbidity after prophylactic NSM with a focus on NAC necrosis was analysed.
Among 59 women undergoing prophylactic NSM, 19 (32 per cent) of the incisions were partly on the NAC. Reconstructions were performed with 46 definitive implants and 13 expanders. The crude rate of postoperative complications was 25 per cent (15 patients). Complete NAC necrosis was reported in two women (3 per cent) and partial or total necrosis in nine (15 per cent). No NAC resection was necessary. Median BMI was lower in women with total or partial NAC necrosis compared with the others (20.0 versus 21.3 kg/m2 respectively; P = 0.034).
Results of this prospective study confirm that prophylactic NSM with IBR is associated with a low risk of total NAC necrosis.
当进行预防性乳房切除术时，越来越多地采用保留乳头的乳房切除术（NSM）联合即刻乳房重建（IBR）。很少有前瞻性研究报告并发症发生率。这项对法国前瞻性多中心 MAPAM 试验的补充试验旨在评估预防性 NSM 联合 IBR 时乳头乳晕复合体（NAC）坏死率。
记录患者特征和手术数据。分析预防性 NSM 术后的发病率，重点关注 NAC 坏死。
在 59 例行预防性 NSM 的女性中，19 例（32%）切口部分位于 NAC 上。重建采用 46 个确定性植入物和 13 个扩张器进行。术后并发症的总发生率为 25%（15 例）。2 名女性（3%）报告完全 NAC 坏死，9 名（15%）报告部分或完全坏死。无需切除 NAC。与其他女性相比，完全或部分 NAC 坏死的女性的 BMI 中位数较低（分别为 20.0 与 21.3kg/m2；P=0.034）。
这项前瞻性研究的结果证实，预防性 NSM 联合 IBR 与总 NAC 坏死的风险较低相关。
