Houvenaeghel Gilles, Bannier Marie, Bouteille Catherine, Tallet Camille, Sabiani Laura, Charavil Axelle, Bertrand Arthur, Van Troy Aurore, Buttarelli Max, Teyssandier Charlène, Tallet Agnès, de Nonneville Alexandre, Cohen Monique
Aix-Marseille University, CNRS (National Center of Scientific Research), INSERM (National Institute of Health and Medical Research), Paoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, France.
Paoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, France.
Cancers (Basel). 2024 Mar 12;16(6):1129. doi: 10.3390/cancers16061129.
Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh.
We analyzed all complications and grade 2-3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR.
Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR ( = 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2-3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2-3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2-3 complications.
Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique.
即刻乳房重建（IBR）技术正在迅速发展。我们比较了单中心植入式IBR队列中，采用和不采用补片的胸肌下和胸肌前植入物的结果。
我们分析了所有并发症和2-3级并发症、植入物丢失率、手术时间、住院时间（LOS）、患者满意度、辅助治疗间隔时间和成本，并对胸肌下和胸肌前植入式IBR进行了比较。
529例乳房切除术（62.0%）采用胸肌下植入式IBR，324例采用胸肌前植入式IBR，近年来胸肌前植入的比例显著增加。176例胸肌前植入（54.3%）使用了补片。147例乳房切除术（17.2%）报告了任何级别的并发症，胸肌前植入式IBR的发生率显著更高（P = 0.036）。回归分析表明，胸肌前植入物与任何级别的并发症或2-3级并发症均无显著相关性。胸肌前植入式IBR的手术时间显著缩短，住院时间更短。2-3级并发症与满意度显著降低相关。更高的成本与胸肌下植入和补片显著相关。一个并发症发生率预测评分确定了五组，2-3级并发症显著增加。
随着时间的推移，胸肌前-M-IBR有所增加，与胸肌下-M-IBR相比，并发症发生率没有差异。胸肌前植入物放置可被认为是一种安全的技术。
