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当前胸肌前乳房重建的全球趋势。

Current Global Trends in Prepectoral Breast Reconstruction.

机构信息

The Royal Wolverhampton N.H.S. Trust, Wolverhampton Road, Wolverhampton WV10 0QP, UK.

出版信息

Medicina (Kaunas). 2024 Mar 3;60(3):431. doi: 10.3390/medicina60030431.

Abstract

Implant-based breast reconstruction (IBBR) is the most frequently performed procedure for breast reconstruction following mastectomy, which involves the surgical placement of breast implants. The approach to breast reconstruction can be divided into two main categories, namely prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR), based on the implant plan and placement technique. In recent years, there has been a significant surge in the popularity of prepectoral implant-based breast reconstruction, where the implants are positioned above the chest muscle, as opposed to beneath it in the subpectoral approach. However, despite this growing preference, there is a lack of comprehensive data regarding the national trends in the utilization of this technique, thus necessitating further investigation. This narrative review aims to ascertain the current global patterns linked to prepectoral breast reconstruction and elucidate the considerations surrounding patient and implant selection, reconstructive techniques, the utilization of meshes in prepectoral reconstruction, the ensuing outcomes and complications, the ramifications of radiotherapy, and the potential advantages of integrating fat infiltration into the implementation of this technique in breast reconstruction with a focus on published papers in last five years. Conclusion: Prepectoral breast reconstruction has emerged as an appropriate surgical option for individuals seeking breast reconstruction. This development can be attributed to the recent progress made in implant technology, which has significantly enhanced the outcomes of this procedure. Additionally, advancements in mastectomy techniques, autologous fat grafting, and the use of acellular dermal matrices (ADMs) have also played a vital role in improving the aesthetic results of prepectoral breast reconstruction. As a result, the significance and effectiveness of this technique in the field of breast reconstruction have been firmly established, making it an essential component of the overall armamentarium available to plastic surgeons for breast reconstruction purposes.

摘要

基于植入物的乳房重建(IBBR)是乳房切除术后乳房重建最常进行的手术,涉及乳房植入物的外科放置。根据植入物计划和放置技术,乳房重建的方法可以分为两大类,即胸肌前乳房重建(PPBR)和胸肌下乳房重建(SPBR)。近年来,胸肌前植入物乳房重建的应用明显增加,植入物位于胸肌上方,而不是胸肌下的胸肌下方法。然而,尽管这种偏好越来越强烈,但对于该技术在全国范围内的应用趋势,缺乏全面的数据,因此需要进一步调查。本叙述性综述旨在确定目前与胸肌前乳房重建相关的全球模式,并阐明围绕患者和植入物选择、重建技术、在胸肌前重建中使用网片、随后的结果和并发症、放射治疗的影响以及将脂肪浸润纳入乳房重建的潜在优势的考虑因素,重点关注过去五年发表的论文。结论:胸肌前乳房重建已成为寻求乳房重建的个体的合适手术选择。这种发展可以归因于植入物技术的最新进展,这大大提高了该手术的效果。此外,乳房切除术技术、自体脂肪移植和脱细胞真皮基质(ADM)的进步也在改善胸肌前乳房重建的美学效果方面发挥了重要作用。因此,该技术在乳房重建领域的重要性和有效性已得到确立,使其成为整形外科医生进行乳房重建的整体武器库中的重要组成部分。

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