Shen Peng, Du Zhenggui, You Wei, Yu Bofan, Yan Yuan, Liu Zhengyi, Yu Yang
Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou Henan, 450003, P. R. China.
Department of General Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Jul 15;38(7):781-785. doi: 10.7507/1002-1892.202404021.
To discuss the effectiveness of breast reconstruction with dual plane prosthesis implantation or anterior pectoralis prosthesis implantation under endoscopy by using prospective comparative study, in order to provide a reference for clinical surgical selection.
A total of 54 female patients with breast cancer admitted between January 2023 and December 2023 and met the selection criteria were selected as research subjects. According to the random number table, 54 patients were divided into trial group and control group with 27 cases in each. The patients in the trial group and control group were treated with dual plane prosthesis implantation and anterior pectoralis prosthesis implantation for breast reconstruction after glandular resection under endoscopy, respectively. There was no significant difference between the two groups ( >0.05) in the terms of age, body mass index, affected side, breast clinical stages, molecular typing, disease duration, breast volume of healthy side, breast ptosis of affected side, and preoperative Breast-Q score (social mental health, sexual health, breast satisfaction, chest somatic health). The operation-related indicators (operation time, total volume of drainage within 7 days after operation, extubation time, and hospital stay), occurrence of complications, breast reconstruction efficacy related indicators (transverse and longitudinal distance difference), and the pre- and post-operative differences (change values) of Breast-Q scores for each item were compared between the two groups.
There was no significant difference in operation time, total volume of drainage within 7 days after operation, extubation time, and hospital stay between the two groups ( >0.05). All patients of the two groups were followed up 3-12 months (mean, 6.3 months). Three patients (11.11%) in trial group and 5 patients (18.52%) in control group experienced complications, and there was no significant difference in the occurrence of complications ( >0.05). At 7 days after operation, the transverse and longitudinal distance differences were significantly less in trial group than in control group ( <0.05). The Breast-Q scores of the two groups at 7 days after operation were significantly higher in all items than those before operation ( <0.05), but there was no significant difference in all change values between the two groups ( >0.05).
For patients with breast cancer, comparison of breast reconstruction with anterior pectoralis prosthesis implantation, breast reconstruction with dual plane prosthesis implantation has better breast reconstruction effectiveness and higher safety.
采用前瞻性对比研究探讨双平面假体植入或内镜下胸大肌前方假体植入进行乳房重建的效果，为临床手术选择提供参考。
选取2023年1月至2023年12月收治的符合入选标准的54例女性乳腺癌患者作为研究对象。根据随机数字表将54例患者分为试验组和对照组，每组27例。试验组和对照组患者分别在内镜下腺体切除术后采用双平面假体植入和胸大肌前方假体植入进行乳房重建。两组患者在年龄、体重指数、患侧、乳房临床分期、分子分型、病程、健侧乳房体积、患侧乳房下垂程度及术前乳房Q评分（社会心理健康、性健康、乳房满意度、胸部躯体健康）方面差异无统计学意义（>0.05）。比较两组患者的手术相关指标（手术时间、术后7天内总引流量、拔管时间、住院时间）、并发症发生情况、乳房重建效果相关指标（横径和纵径差值）以及各项目乳房Q评分的术前术后差值（变化值）。
两组患者的手术时间、术后7天内总引流量、拔管时间、住院时间差异无统计学意义（>0.05）。两组患者均随访3 - 12个月（平均6.3个月）。试验组3例患者（11.11%）、对照组5例患者（18.52%）出现并发症，并发症发生率差异无统计学意义（>0.05）。术后7天，试验组的横径和纵径差值明显小于对照组（<0.05）。两组患者术后7天各项目乳房Q评分均明显高于术前（<0.05），但两组所有变化值差异无统计学意义（>0.05）。
对于乳腺癌患者，与胸大肌前方假体植入乳房重建相比，双平面假体植入乳房重建具有更好的乳房重建效果和更高的安全性。
