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应用腓肠神经移植的新型乳头再神经支配技术。

Novel Nipple Reinnervation Technique Using N. Suralis Graft.

机构信息

Department of Doctoral Studies, Rīga Stradiņš University, LV-1007 Riga, Latvia.

Pauls Stradiņš Clinical University Hospital, LV-1002 Riga, Latvia.

出版信息

Medicina (Kaunas). 2024 Sep 20;60(9):1533. doi: 10.3390/medicina60091533.

Abstract

Following nipple-sparing mastectomy (NSM), patients commonly experience significant impairment or total loss of nipple sensitivity, which negatively impacts the patients' quality of life, whereas patients who retain nipple sensation postoperatively experience enhanced physical, psychosocial, and sexual well-being. Reinnervation techniques such as nerve allografting have been utilized to retain sensation. Despite the benefits of nerve allografts, such as lack of donor site morbidity, ease of use, and potentially shorter surgery time, there are shortcomings, such as the cost of commercially available acellular nerve allografts, and, most importantly, decreased sensory and motor function recovery for acellular nerve allografts with a diameter greater than 3 mm or a length greater than 50 mm. We present a technique where we performed immediate implant-based breast reconstruction combined with nipple-areola complex reinnervation using an autologous nerve graft. Following the procedure, the patient had improved sensory outcomes in the reconstructed breast and good quality-of-life indices. This report highlights the potential for sural nerve autografts in restoring breast sensation following mastectomy.

摘要

行保留乳头的乳房切除术(NSM)后,患者常经历显著的乳头感觉丧失或完全丧失,这对患者的生活质量产生负面影响,而术后保留乳头感觉的患者则经历增强的身体、心理社会和性健康。神经移植等再神经支配技术已被用于保留感觉。尽管神经移植物有一些益处,如无供区发病率、易于使用和潜在的更短手术时间,但也存在一些缺点,如商业上可获得的去细胞神经移植物的成本,以及最重要的是,对于直径大于 3 毫米或长度大于 50 毫米的去细胞神经移植物,感觉和运动功能的恢复会降低。我们提出了一种技术,即使用自体神经移植物进行即刻基于植入物的乳房重建和乳晕复合体再神经支配。手术后,患者在重建乳房中具有改善的感觉结果和良好的生活质量指数。该报告强调了腓肠神经自体移植物在乳房切除术后恢复乳房感觉的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af8/11433809/799b26709632/medicina-60-01533-g001.jpg

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