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下蒂缩乳术作为保乳手术及放疗后的矫正手术

Inferior Pedicle Reduction Mammoplasty as Corrective Surgery after Breast Conserving Surgery and Radiation Therapy.

作者信息

Atzori Giulia, Franchelli Simonetta, Gipponi Marco, Cornacchia Chiara, Diaz Raquel, Depaoli Francesca, Murelli Federica, Sparavigna Marco, Fregatti Piero, Friedman Daniele

机构信息

Breast Surgery Clinic, San Martino Policlinic Hospital, 16132 Genoa, Italy.

Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132 Genoa, Italy.

出版信息

J Pers Med. 2022 Sep 23;12(10):1569. doi: 10.3390/jpm12101569.

Abstract

Background/Aim-Twenty patients had corrective reconstruction surgery by means of a reduction mammaplasty or mastopexy after a previous BCS (Breast Conserving Surgery) and RT (Radiation Therapy); the risk factors and post-operative complications were reported in order to define a safe and effective technique for reduction mammaplasty in previously irradiated breast cancer patients. Materials and Methods-From June 2011 to December 2019, 20 pts. were operated on at the Breast Surgery Clinic of San Martino Policlinic Hospital, Genoa, Italy. Pre- and post-operative parameters included clinic-pathological features of the primary tumor; a lapse of time from primary radio-surgery; the extent of follow-up; the rate of post-operative wound infections; the persistence of breast asymmetry, and a post-operative patient satisfaction index by means of a BREAST-Q questionnaire. Results-Three patients (15%) developed minor complications in the irradiated breast, but no complication was observed into the non-irradiated breast. No statistically significant correlation was found between the post-operative complications and the risk factors. The statistical analysis of BREAST-Q questionnaire responses gave an average patient's satisfaction index that was equal to 90.8/100 (range: 44 to 100). Conclusions-Inferior pedicle reduction mammoplasty is an effective reduction mammoplasty technique in regard to the extent of breast tissues that are to be removed both in irradiated and contralateral breast; moreover, the incidence of post-operative complications is clearly limited when a careful technique is adopted, and it can be reasonably applied also in patients with co-morbidity factors.

摘要

背景/目的——20例患者在先前接受保乳手术(BCS)和放疗(RT)后,通过乳房缩小成形术或乳房上提术进行了矫正重建手术;报告了风险因素和术后并发症,以确定一种针对先前接受过放疗的乳腺癌患者进行乳房缩小成形术的安全有效技术。材料与方法——2011年6月至2019年12月,20例患者在意大利热那亚圣马蒂诺综合医院乳腺外科接受手术。术前和术后参数包括原发肿瘤的临床病理特征;自原发放射外科手术以来的时间间隔;随访范围;术后伤口感染率;乳房不对称的持续情况,以及通过BREAST-Q问卷得出的术后患者满意度指数。结果——3例患者(15%)在接受放疗的乳房出现轻微并发症,但未在未接受放疗的乳房观察到并发症。术后并发症与风险因素之间未发现统计学上的显著相关性。对BREAST-Q问卷回复的统计分析得出患者平均满意度指数为90.8/100(范围:44至100)。结论——就待切除的放疗侧和对侧乳房组织范围而言,下蒂乳房缩小成形术是一种有效的乳房缩小成形术;此外,采用谨慎的技术时,术后并发症的发生率明显受限,并且它也可合理应用于有合并症因素的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e23c/9605670/159e54221894/jpm-12-01569-g001.jpg

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