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采用“箭形皮瓣”技术进行乳头重建:结果和患者满意度。

Nipple Reconstruction Using the "Arrow Flap" Technique: Outcomes and Patients Satisfaction.

机构信息

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy.

Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy.

出版信息

Clin Breast Cancer. 2024 Jun;24(4):e226-e231. doi: 10.1016/j.clbc.2024.01.011. Epub 2024 Jan 24.

Abstract

INTRODUCTION

Skin-sparing mastectomy (SSM) entails complete removal of the breast tissue and the nipple and areola complex (NAC) with preservation of as much of the overlying skin as possible. The preservation of the natural skin envelope during SSM improves the aesthetic outcome of immediate breast reconstruction, but the lack of NAC determines that the reconstructed breast remains anatomically incomplete with not always satisfactory final results. For this purpose, the aim of the present study was to investigate and evaluate the impact of nipple reconstruction after skin sparing and skin reducing mastectomy on the patients' perception and intimate life.

MATERIALS AND METHOD

This was a comparative single-center prospective study that involved 42 patients underwent NAC reconstruction after SSM. A pre- and postoperative quality-of-life and psychological questionnaires Breast-Q questionnaire (Breast Conserving therapy module) were given to all the patients before the surgery and 6 months after. The statistical analysis with chi-square test was performed.

RESULTS

After 6 months a prevalence of patients reported to be very satisfied in regard to shape, appearance, naturalness, projection, position and symmetry. The study shows an overall improvement in all the psychological items analyzed with statistically significant difference regarding: "patient's satisfaction," "self-confidence," "appearance of the breast."

CONCLUSION

The authors believe that the NAC reconstruction has useful functional and aesthetic results particularly appreciated by patients who feel demoralized after breast demolition surgery.

摘要

简介

保留皮肤的乳房切除术(SSM)需要完整切除乳房组织和乳头乳晕复合体(NAC),同时尽可能保留尽可能多的覆盖皮肤。在 SSM 中保留自然皮肤包膜可改善即刻乳房重建的美学效果,但 NAC 的缺失决定了重建的乳房在解剖上仍然不完整,最终结果并不总是令人满意。为此,本研究旨在探讨和评估 SSM 后行乳头重建对患者感知和亲密生活的影响。

材料和方法

这是一项比较单中心前瞻性研究,共纳入 42 例接受 SSM 后 NAC 重建的患者。所有患者在手术前和手术后 6 个月均接受了乳房质量和心理问卷(乳房保留治疗模块)的术前和术后生活质量和心理问卷。采用卡方检验进行统计学分析。

结果

6 个月后,有相当比例的患者报告在形状、外观、自然度、突出度、位置和对称性方面非常满意。研究显示,所有分析的心理项目均有整体改善,在“患者满意度”、“自信心”、“乳房外观”方面具有统计学显著差异。

结论

作者认为,NAC 重建具有有用的功能和美学效果,特别是对那些在乳房切除手术后感到沮丧的患者有帮助。

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