Jeon Hong Bae, Lee Minyoung, Roh Tai Suk, Jeong Joon, Ahn Sung Gwe, Bae Soong June, Lee Nara, Kim Young Seok
Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Department of Plastic and Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Breast Cancer. 2023 Feb;26(1):25-34. doi: 10.4048/jbc.2023.26.e7.
Implant-based breast reconstruction is the most common reconstruction method used after mastectomy in breast cancer patients. Many studies have compared the smooth round implants and textured anatomical implants. This study aimed to compare the complications, including capsular contracture, between these two implants used in direct-to-implant (DTI) breast reconstruction.
This retrospective chart review was performed using a prospectively maintained database from a single center. We identified patients who underwent mastectomy with DTI single-stage breast reconstruction at our hospital between August 2011 and June 2021. The overall complications, including capsular contracture, postoperative infection, seroma, hematoma, implant rupture, implant exposure, rippling, implant malposition, and nipple necrosis, were analyzed.
In total, 340 breasts of 323 patients were reconstructed by the DTI approach using either textured anatomical (n = 203) or smooth round (n = 137) implants. The incidence of overall complications and capsular contracture was significantly lower with smooth round implants than with textured anatomical implants. Multivariate analysis showed that smooth round implants were associated with a reduced risk of overall complications (odds ratio [OR], 0.465; 95% confidence interval [CI], 0.265-0.813) and capsular contracture (OR, 0.475; 95% CI, 0.235-0.962). Particularly, smooth round implants were associated with a decreased risk of overall complications in patients not receiving adjuvant chemotherapy and a decreased risk of capsular contracture in patients with body mass index < 25 kg/m² and in those not receiving adjuvant radiotherapy.
Smooth round implants demonstrated a decreased risk of overall complications and capsular contracture when compared with textured anatomical implants. These results may be utilized in counseling patients regarding the advantages and disadvantages of smooth round implants in DTI breast reconstruction.
基于植入物的乳房重建是乳腺癌患者乳房切除术后最常用的重建方法。许多研究比较了光面圆形植入物和带纹理的解剖型植入物。本研究旨在比较这两种用于直接植入式（DTI）乳房重建的植入物的并发症，包括包膜挛缩。
本回顾性图表审查使用了来自单一中心的前瞻性维护数据库。我们确定了2011年8月至2021年6月期间在我院接受DTI单阶段乳房重建乳房切除术的患者。分析了包括包膜挛缩、术后感染、血清肿、血肿、植入物破裂、植入物外露、波纹、植入物位置异常和乳头坏死在内的总体并发症。
共有323例患者的340个乳房通过DTI方法使用带纹理的解剖型植入物（n = 203）或光面圆形植入物（n = 137）进行了重建。光面圆形植入物的总体并发症和包膜挛缩发生率明显低于带纹理的解剖型植入物。多因素分析表明，光面圆形植入物与总体并发症风险降低相关（优势比[OR]，0.465；95%置信区间[CI]，0.265 - 0.813）和包膜挛缩风险降低相关（OR，0.475；95%CI，0.235 - 0.962）。特别是，光面圆形植入物与未接受辅助化疗患者的总体并发症风险降低以及体重指数<25 kg/m²且未接受辅助放疗患者的包膜挛缩风险降低相关。
与带纹理的解剖型植入物相比，光面圆形植入物显示出总体并发症和包膜挛缩风险降低。这些结果可用于在咨询患者时说明光面圆形植入物在DTI乳房重建中的优缺点。
