Plastic and Reconstructive Surgery department, I.R.C.C.S. "Regina Elena" National Cancer Institute, Rome, RM, Italy.
Plastic and Reconstructive Surgery department, I.R.C.C.S. "Regina Elena" National Cancer Institute, Rome, RM, Italy.
Clin Breast Cancer. 2024 Oct;24(7):e613-e621. doi: 10.1016/j.clbc.2024.06.004. Epub 2024 Jun 12.
Breast reconstructive surgery has evolved significantly over the years. One of the recent advancements is the use of prepectoral implants in combination with synthetic and biological material as a natural and effective coverage. To date, there is little published data on breast reconstruction using acellular bovine pericardium matrix and most concern submuscular breast reconstruction. This study aimed to describe the multicentric-multisurgeon experience in performing direct to implant (DTI) prepectoral breast reconstructions using acellular bovine pericardium matrix (ABPM) pocket. A retrospective multicentric data collection of the all the immediate prepectoral breast reconstructions using acellular bovine pericardium was carried out by the authors. Surgical data including type of mastectomy, axillary surgery, type and size of implant, size of ABPM, duration of surgery were collected for each patient. Postoperative data including adjuvant treatments, complications, necessity to perform other interventions, patient's satisfaction were collected. Cosmetic results were also evaluated by 7 different observers at minimum 1 year follow-up. A total of 65 breast reconstruction were included in the study. Mean follow up was 21.3 months. Average surgical time was 1,42 hours. Minor complications occurred in 4 breasts; major complications occurred in 2 breasts. After 6 months follow-up, 7 patients underwent fat grafting to correct any rippling and /or wrinkling. Breast aesthetic and patients reported outcomes were satisfactory. Not significant capsular contracture was noted at the follow up control. To date, this is the largest study about prepectoral breast reconstruction with ABPM. On the basis of our results, prepectoral breast reconstruction ABPM assisted is a reliable, safe and suitable option providing good patient satisfaction outcomes.
乳房重建术近年来取得了显著进展。最近的一项进展是使用预制胸假体,结合合成和生物材料,作为一种自然有效的覆盖物。迄今为止,关于使用去细胞牛心包基质进行乳房重建的文献很少,大多数人关注的是胸肌下乳房重建。本研究旨在描述多中心多外科医生使用去细胞牛心包基质(ABPM)口袋进行直接到植入物(DTI)预制胸乳房重建的经验。作者对所有使用去细胞牛心包即刻预制胸乳房重建进行了回顾性多中心数据收集。收集了每位患者的手术数据,包括乳房切除术的类型、腋窝手术、植入物的类型和大小、ABPM 的大小、手术持续时间。收集了术后数据,包括辅助治疗、并发症、是否需要进行其他干预、患者满意度。至少在 1 年随访时,由 7 位不同的观察者评估美容结果。本研究共纳入 65 例乳房重建。平均随访时间为 21.3 个月。平均手术时间为 1.42 小时。4 例乳房发生轻微并发症;2 例乳房发生严重并发症。6 个月随访后,7 例患者行脂肪移植以纠正任何波纹和/或皱纹。乳房美观和患者报告的结果令人满意。在随访时,未发现明显的包膜挛缩。迄今为止,这是关于预制胸乳房重建 ABPM 的最大研究。根据我们的结果,预制胸 ABPM 辅助乳房重建是一种可靠、安全和合适的选择,能提供良好的患者满意度。