Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan; Department of Plastic and Reconstructive Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan.
Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
J Plast Surg Hand Surg. 2024 Oct 15;59:128-131. doi: 10.2340/jphs.v59.39952.
Breast animation is a common postoperative complication of breast reconstruction surgery. This study investigates the factors affecting the onset and degree of animation to suggest an ideal treatment strategy for this complication.
This study included patients who underwent latissimus dorsi reconstruction at Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, between 2009 and 2020 and had an outpatient visit after July 2020. Statistical analysis was performed and the patients' background and surgical factors were examined to determine whether they affected the animation incidence rate.
The animation incidence rate was 69.6%. There was no significant relationship between animation incidence and any patient background or surgical factors, except for the complete dissection of insertion into the humerus of the latissimus dorsi muscle (p = 0.0039). The rate of uncomfortable animation was 4% and recurrence of animation was observed in one of the two patients who underwent denervation.
Prophylactic denervation is not considered necessary and should be offered only for persistent discomfort with animation. Instead, the muscle insertion must be dissected during flap elevation to prevent animation, and the thoracodorsal nerve must be preserved to avoid muscle atrophy.
乳房运动是乳房重建手术后常见的一种术后并发症。本研究旨在探讨影响乳房运动发生和严重程度的因素，为该并发症提供理想的治疗策略。
本研究纳入了 2009 年至 2020 年期间在东京都癌症和传染病中心驹込医院接受背阔肌重建术的患者，且在 2020 年 7 月后有门诊随访。对患者的背景和手术因素进行统计学分析，以确定其是否影响乳房运动的发生率。
乳房运动的发生率为 69.6%。除了背阔肌插入肱骨的完全解剖（p=0.0039）外，乳房运动的发生率与任何患者背景或手术因素均无显著关系。有 4%的患者出现运动不适，且在接受神经切断术的两名患者中，有一名出现乳房运动复发。
预防性神经切断术不被认为是必要的，仅应在出现持续不适的情况下使用。相反，在皮瓣抬起时必须解剖肌肉插入部位以防止乳房运动，并且必须保留胸背神经以避免肌肉萎缩。
