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经皮内窥镜/机器人辅助下即刻胸肌下假体乳房重建中补片应用的患者报告结局:一项回顾性研究。

Patient-reported outcomes of mesh in minimally invasive (laparoscopic/robot-assisted) immediate subpectoral prosthesis breast reconstruction: a retrospective study.

机构信息

Breast Disease Center, The First Affiliated Hospital, Army Medical University, Gaotanyan Main Street 30, Shapingba District, Chongqing, China.

出版信息

Breast Cancer. 2024 Mar;31(2):243-251. doi: 10.1007/s12282-023-01529-3. Epub 2024 Feb 2.

Abstract

BACKGROUND

Although there is increasing interest in minimally invasive prosthesis breast reconstruction (PBR), whether meshes application in minimally invasive PBR can improve complications and cosmetic effects remains controversial. The author retrospectively analyzed postoperative complications and evaluated patient-reported quality-of-life outcomes in minimally invasive PBR with and without mesh.

METHODS

This study enrolled patients who underwent minimally invasive nipple-sparing mastectomy (NSM) followed by PBR. We used the TiLOOP bra for the mesh-assisted procedure. Patient demographics and postoperative complications data were compared between the procedures. Patient-reported outcomes were evaluated with the Breast-Q.

RESULTS

A total of 158 patients underwent 160 minimally invasive NSM-PBR (with mesh, n = 64; without, n = 94). Postoperative complications were comparable in the mesh-assisted (5 [7.7%]) and non-mesh-assisted (5 [5.3%]) groups (p = 0.533). The most common complication in non-mesh-assisted group was infection, with four (4.2%) cases. In mesh-assisted group, implant exposure occurred in two (3.1%) patients. Removal of prosthesis was uncommon, with two (3.1%) and three (3.2%) cases in the mesh-assisted and non-mesh groups, respectively (p = 0.977). The BREAST-Q questionnaire was completed by 52 (81.3%) patients in the mesh-assisted group and 68 (72.3%) in the non-mesh-assisted group. Comparing the non-mesh group, patients in mesh-assisted group had improved scores on the BREAST-Q Satisfaction with breast (66.0) (p < 0.05), Physical Well-being (80.0), and Sexual Well-being (56.0).

CONCLUSIONS

Mesh-assisted minimally invasive NSM-PBR has good aesthetic outcomes and high patient satisfaction. There were no significant differences in complication rates between the mesh-assisted and non-mesh-assisted groups.

摘要

背景

尽管微创假体乳房重建(PBR)的兴趣日益增加,但在微创 PBR 中应用网片是否能改善并发症和美容效果仍存在争议。作者回顾性分析了微创 PBR 中应用和不应用网片的术后并发症,并评估了患者报告的生活质量结果。

方法

本研究纳入了接受微创乳头保留乳房切除术(NSM)后行 PBR 的患者。我们使用 TiLOOP 胸罩进行网片辅助手术。比较了两种手术的患者人口统计学和术后并发症数据。使用 Breast-Q 评估患者报告的结果。

结果

共有 158 名患者接受了 160 例微创 NSM-PBR(带网片,n=64;不带网片,n=94)。网片辅助组(5[7.7%])和非网片辅助组(5[5.3%])的术后并发症相似(p=0.533)。非网片辅助组最常见的并发症是感染,有 4 例(4.2%)。网片辅助组有 2 例(3.1%)患者出现假体暴露。假体取出并不常见,网片组和非网片组分别有 2 例(3.1%)和 3 例(3.2%)(p=0.977)。网片辅助组有 52 例(81.3%)患者完成了 BREAST-Q 问卷,非网片辅助组有 68 例(72.3%)。与非网片组相比,网片组患者在 BREAST-Q 乳房满意度(66.0)(p<0.05)、身体舒适度(80.0)和性健康(56.0)方面的评分均有所提高。

结论

微创 NSM-PBR 联合网片具有良好的美学效果和患者满意度。网片辅助组和非网片辅助组的并发症发生率无显著差异。

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