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15 例患者行根治性乳房切除术即刻乳房重建中单纯应用自体脂肪移植的临床疗效分析

Autologous Fat Grafting as a Stand-alone Method for Immediate Breast Reconstruction After Radical Mastectomy in a Series of 15 Patients.

机构信息

Department of Medical Education, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar.

出版信息

Ann Plast Surg. 2022 Jan 1;88(1):25-31. doi: 10.1097/SAP.0000000000002894.

Abstract

OBJECTIVE

To date, breast reconstruction after mastectomy essentially uses flap- or prosthetic-based surgery. Autologous fat grafting (AFT) largely used in breast conservative surgery is considered an additional technique in breast reconstruction. The aim of this retrospective study was to report our experience of AFT as a stand-alone method for immediate breast reconstruction.

PATIENTS AND METHODS

Fifteen patients requiring a radical mastectomy underwent AFT for immediate reconstruction since 2014. Previous breast irradiation was not a contraindication. Procedures, complications, and cosmetic results were retrospectively analyzed.

RESULTS

Fifteen patients with an average age of 60.5 (43-78) years were included in this retrospective study. They had a body mass index ranging from 19 to 40. Fourteen had a mastectomy for cancer and 1 for prophylaxis. Nine received breast irradiation (7 before surgery and 2 adjuvant). A mean of 3 (2-6) AFT procedures were required to achieve total breast reconstruction. Except for the first transfer, others were performed as outpatient surgeries. Only 2 minor complications (1 hematoma and 1 abscess) not impairing results were reported. The results after a mean follow-up of 26 months were considered by the patients and surgeon as highly satisfactory even in previously irradiated breast, as assessed using a qualitative scoring analysis.

CONCLUSIONS

Autologous fat grafting as a stand-alone method for immediate breast reconstruction after radical mastectomy is a safe procedure with very consistent results even for patients requiring radiation therapy.

摘要

目的

迄今为止,乳房切除术后的乳房重建主要采用皮瓣或假体手术。自体脂肪移植(AFT)在保乳手术中广泛应用,被认为是乳房重建的附加技术。本回顾性研究旨在报告我们将 AFT 作为一种独立方法用于即刻乳房重建的经验。

患者与方法

自 2014 年以来,15 例需要根治性乳房切除术的患者因即刻重建而接受 AFT。既往乳房放疗不是禁忌症。回顾性分析手术过程、并发症和美容效果。

结果

本回顾性研究共纳入 15 例平均年龄为 60.5 岁(43-78 岁)的患者。他们的体重指数范围为 19 至 40。14 例因癌症而行乳房切除术,1 例为预防性切除。9 例接受了乳房放疗(7 例术前,2 例辅助)。为了实现全乳重建,平均需要进行 3(2-6)次 AFT 手术。除了第一次转移,其他手术均作为门诊手术进行。仅报告了 2 例轻微并发症(1 例血肿,1 例脓肿),不影响结果。在平均 26 个月的随访后,患者和外科医生认为结果非常满意,即使是在以前接受过放疗的乳房中,也通过定性评分分析进行了评估。

结论

自体脂肪移植作为根治性乳房切除术后即刻乳房重建的一种独立方法,是一种安全的手术,即使对于需要放疗的患者,结果也非常一致。

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