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韩国乳房植入危机背景下,外科医生对术前应用高分辨率超声检测破裂的经验性观点。

A Surgeon's Empirical Perspectives on Use of High-resolution Ultrasound in Preoperatively Detecting a Rupture in the Context of Breast Implant Crisis in Korea.

机构信息

Yang Hospital, Namyangju-si, Gyeonggi, Korea.

Department of Anesthesiology and Pain medicine, Cheju Halla General Hospital, Jeju, Korea.

出版信息

Aesthetic Plast Surg. 2022 Aug;46(4):1668-1678. doi: 10.1007/s00266-022-02844-4. Epub 2022 Mar 16.

Abstract

BACKGROUND

We previously proposed a novel method for detecting a rupture of a breast implant using high-resolution ultrasound (HRUS). We therefore conducted this retrospective, observational study to describe its feasibility in making a preoperative diagnosis of rupture of the device in patients receiving an implant-based augmentation mammaplasty.

METHODS

We initially evaluated the medical records of the patients who had received primary or secondary augmentation mammaplasty using a breast implant at other hospitals for aesthetic or reconstructive purposes between August 31, 2017, and August 31, 2020. The patients underwent breast US using the Aplio i600 (Canon Medical System, Otawara, Tochigi, Japan) system with a 7-18 MHz linear transducer. Through a retrospective review of the patients' medical records, we analyzed their baseline and clinical characteristics. Then, we compared an agreement between preoperative diagnosis of rupture on HRUS and findings at reoperation.

RESULTS

A total of 29 patients with rupture (55 breasts) were evaluated for the performance of ultrasound in making a diagnosis of rupture. This showed that they were unaware of rupture but they were diagnosed with it on ultrasound. Preoperatively, there were no cases of rupture in 110 left breasts (80.9%) and 107 right breasts (78.7%), which exactly matched to the number of breasts without rupture on HRUS. Moreover, preoperatively, there were 26 (19.1%) and 29 cases (21.3%) of rupture in the left and right breast, respectively, which exactly matched to the number of breasts with rupture on HRUS.

CONCLUSIONS

In conclusion, patients who are suspected of having rupture of a breast implant should be stringently evaluated for presence of rupture and, if any, its scope using HRUS. Moreover, we propose that surgeons consider using HRUS in making a preoperative diagnosis of rupture of a breast implant.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

我们之前提出了一种使用高分辨率超声(HRUS)检测乳房植入物破裂的新方法。因此,我们进行了这项回顾性观察研究,以描述其在接受基于植入物的隆乳术的患者中对设备破裂进行术前诊断的可行性。

方法

我们最初评估了 2017 年 8 月 31 日至 2020 年 8 月 31 日期间在其他医院因美容或重建目的接受原发性或继发性隆乳术的患者的病历。患者接受了使用 Aplio i600(佳能医疗系统公司,栃木县 Otawara 市)系统和 7-18MHz 线性换能器的乳房超声检查。通过回顾患者的病历,我们分析了他们的基线和临床特征。然后,我们比较了 HRUS 术前诊断破裂与再次手术结果的一致性。

结果

共有 29 例破裂(55 只乳房)患者接受了超声检查以诊断破裂。这表明他们不知道破裂,但在超声检查中被诊断为破裂。术前,110 只左侧乳房(80.9%)和 107 只右侧乳房(78.7%)均无破裂,与 HRUS 无破裂的乳房数量完全匹配。此外,术前左侧乳房和右侧乳房分别有 26 例(19.1%)和 29 例(21.3%)破裂,与 HRUS 有破裂的乳房数量完全匹配。

结论

总之,怀疑乳房植入物破裂的患者应严格评估破裂的存在及其范围,并使用 HRUS。此外,我们建议外科医生考虑使用 HRUS 进行乳房植入物破裂的术前诊断。

证据水平 III:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266。

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