三维扫描在基于植入物的乳房重建中真的有用吗?一项前瞻性研究。
Is 3-Dimensional Scanning Really Helpful in Implant-Based Breast Reconstruction?: A Prospective Study.
机构信息
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
出版信息
Ann Plast Surg. 2022 Mar 1;88(1s Suppl 1):S85-S91. doi: 10.1097/SAP.0000000000003088.
BACKGROUND
Breast reconstruction is an integral part of breast cancer treatment, and implant-based breast reconstruction is the most commonly used method worldwide. However, there is still no technique that allows surgeons to predict the volume of the required implant. Although computed tomography and magnetic resonance imaging provide adequate representations of the breast, these procedures are time-consuming, expensive, and expose patients to radiation. Therefore, there is a need for safer, noninvasive alternatives for preoperative breast volume measurements.
PATIENTS AND METHODS
This study is a prospective review of 12 patients with early-stage breast cancer who underwent nipple-sparing mastectomy and immediate breast reconstruction with implants. Preoperatively, the Artec Eva 3D scanner was used to acquire volumetric measurements of the breasts. Intraoperatively, the volume of the mastectomy specimen was measured using the water displacement method. Correlations among the preoperative breast, mastectomy specimen, and estimated and final implant volumes were analyzed through Pearson correlation coefficient. A correction prediction factor of 85% was applied where necessary. Patient and physician satisfaction were evaluated 3 months postoperatively.
RESULTS
Our study found a statistically significant correlation between the preoperative breast volumes measured by the Artec Eva 3D scanner and intraoperative mastectomy specimen volumes (r = 0.6578). There was no correlation between the preoperative breast volumes and final implant volumes, mastectomy specimen volumes and final implant volumes, and estimated implant volumes and final implant volumes.
CONCLUSIONS
Although the Artec Eva 3D scanner can offer relatively accurate measurement of breast volumes, multiple studies still need to be done to determine how these data can be applied to the mastectomy procedure and breast implant selection. It may be more applicable for preoperative planning in breast augmentation surgery. Future surgeons should also take into account that variabilities in natural breast size, tumor size, cancer stage, and in patient and physician preferences all influence the outcome of breast reconstruction surgery.
背景
乳房重建是乳腺癌治疗的一个组成部分,基于植入物的乳房重建是全球最常用的方法。然而,仍然没有一种技术可以让外科医生预测所需植入物的体积。虽然计算机断层扫描和磁共振成像可以提供足够的乳房表示,但这些程序耗时、昂贵,并使患者暴露在辐射下。因此,需要更安全、非侵入性的替代方案来进行术前乳房体积测量。
患者和方法
本研究是对 12 例早期乳腺癌患者进行的前瞻性回顾,这些患者接受了保留乳头的乳房切除术和即刻植入物乳房重建。术前,使用 Artec Eva 3D 扫描仪获取乳房的体积测量值。术中,使用水置换法测量乳房切除术标本的体积。通过 Pearson 相关系数分析术前乳房、乳房切除术标本、估计和最终植入物体积之间的相关性。在必要时应用了 85%的校正预测因子。术后 3 个月评估患者和医生的满意度。
结果
我们的研究发现,Artec Eva 3D 扫描仪测量的术前乳房体积与术中乳房切除术标本体积之间存在统计学显著相关性(r = 0.6578)。术前乳房体积与最终植入物体积、乳房切除术标本体积与最终植入物体积以及估计植入物体积与最终植入物体积之间均无相关性。
结论
虽然 Artec Eva 3D 扫描仪可以提供相对准确的乳房体积测量值,但仍需要进行多项研究以确定如何将这些数据应用于乳房切除术程序和乳房植入物选择。它可能更适用于乳房增大手术的术前规划。未来的外科医生还应考虑到自然乳房大小、肿瘤大小、癌症分期以及患者和医生偏好的变异性等因素,这些因素都会影响乳房重建手术的结果。