经乳晕小切口内镜辅助取出聚丙烯酰胺水凝胶（PAAG）后即刻行假体乳房再造。

Immediate prosthetic breast reconstruction after removal of the polyacrylamide hydrogel (PAAG) through a small areolar incision assisted with an endoscope.

机构信息

General Surgery, Cancer Center, Department of Breast Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.

出版信息

BMC Surg. 2022 Sep 7;22(1):332. doi: 10.1186/s12893-022-01778-7.

DOI:10.1186/s12893-022-01778-7

PMID:36071418

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9450310/

Abstract

BACKGROUND

To identify the feasibility, safety, cosmetic outcomes and patient satisfaction of immediate prosthetic breast reconstruction after removal of Polyacrylamide Hydrogel (PAAG) through a small areolar incision assisted with an endoscope.

METHODS

This was a retrospective study. Medical records of 87 patients who underwent PAAG removal were reviewed retrospectively from February 2010 to December 2019. These patients were dichotomized based on whether they accepted immediate prosthetic breast reconstruction after PAAG removal or not. A comprehensive analysis on the data was conducted to observe the surgical results, cosmetic outcomes, health-related quality of life (HRQOL) and patient satisfaction.

RESULTS

Sixty-two patients underwent PAAG removal through a small areolar incision assisted with an endoscope, while another 25 patients underwent further immediate prosthetic breast reconstruction after PAAG removal. All the patients recovered smoothly after operation. In the immediate breast reconstructed group, most of the breasts were natural in appearance, but one patient had mild nipple and breast asymmetry, and another had mild breast asymmetry. Three patients had PAAG residual, and one of them accepted fine needle aspiration. The cosmetic satisfaction rate was 88% and 92% by surgeons and patients, respectively. In the other group, seven patients suffered from PAAG residual, one patient suffered from postoperative bleeding, and five patients suffered from skin laxity. The BREAST-Q scores revealed that patients who accepted immediate breast reconstruction had significant better outcomes in psychosocial well-being (p = 0.030), satisfaction with breasts (p = 0.021), when compared to patients who only accepted PAAG removal, while similar in sexual well-being (p = 0.081), physical well-being chest (p = 0.124), and satisfaction with outcomes (p = 0.068), and satisfaction with care (p = 0.077).

CONCLUSION

Immediate prosthetic breast reconstruction after PAAG removal through a small areolar incision aided with an endoscope might be a viable and safe technique, with better psychosocial well-being and satisfaction with breasts.

摘要

背景

通过乳晕小切口辅助内窥镜检查取出聚丙烯酰胺水凝胶（PAAG）后，即刻行假体乳房再造，以确定其可行性、安全性、美容效果和患者满意度。

方法

这是一项回顾性研究。回顾性分析 2010 年 2 月至 2019 年 12 月期间 87 例接受 PAAG 取出术患者的病历资料。根据患者是否接受 PAAG 取出术后即刻行假体乳房再造，将其分为两组。对两组患者的手术结果、美容效果、健康相关生活质量（HRQOL）和患者满意度进行综合分析。

结果

62 例患者经乳晕小切口辅助内窥镜检查取出 PAAG，25 例患者进一步行 PAAG 取出术后即刻假体乳房再造。所有患者术后均恢复顺利。即刻乳房重建组中，大部分乳房外观自然，但 1 例患者乳头和乳房轻度不对称，另 1 例患者乳房轻度不对称。3 例患者 PAAG 残留，其中 1 例接受了细针抽吸。外科医生和患者对美容满意度的评分分别为 88%和 92%。在另一组中，7 例患者 PAAG 残留，1 例患者术后出血，5 例患者皮肤松弛。BREAST-Q 评分显示，与仅接受 PAAG 取出术的患者相比，接受即刻乳房重建的患者在社会心理健康（p=0.030）、乳房满意度（p=0.021）方面有显著改善，而在性健康（p=0.081）、胸部身体状况（p=0.124）和结果满意度（p=0.068）以及护理满意度（p=0.077）方面差异无统计学意义。