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肿瘤整形保乳手术中脱细胞真皮基质的长期形态和体积维持：一项为期2年的回顾性研究。

Long-Term Shape and Volume Retention of Acellular Dermal Matrix in Oncoplastic Breast-Conserving Surgery: A 2-Year Retrospective Study.

作者信息

Yi Hyung-Suk, Park Jeong-Jin, Park Jin-Hyung, Kim Hong-Il, Yun Jong-Hyouk, Jung Sung-Ui, Choi Jin-Hyuk, Kim Ku-Sang, Kim Yoon-Soo

机构信息

Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea.

Department of Radiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea.

出版信息

J Clin Med. 2025 Apr 26;14(9):3002. doi: 10.3390/jcm14093002.

DOI:10.3390/jcm14093002
PMID:40364034
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12072617/
Abstract

: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. : This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement (2020-2022). Patients received either diced ADM with sheet ADM ( = 102) or diced ADM with paste ADM (n = 70). The ADM volume was evaluated using MRI at 6, 12, and 24 months postoperatively. : Long-term volume stability was achieved in both groups with minimal volume reduction (4.3-4.5%) at 24 months ( < 0.001). Early surgical complications included hematoma (4.1%), seroma (2.3%), and wound issues (1.2%), with no infections or ADM non-incorporation. Contour irregularities occurred in 16.3% of cases. Radiotherapy (87% of patients) did not significantly impact ADM volume retention. : ADM provides predictable, durable volume replacement in OBCS, with excellent volume stability even with radiotherapy. This quantitative assessment of ADM volume retention over two years supports ADM as a reliable option for breast-conserving surgery, potentially expanding treatment options for patients with unfavorable tumor-to-breast volume ratios.

摘要

目的

定量评估肿瘤整形保乳手术（OBCS）中脱细胞真皮基质（ADM）的长期容积稳定性，并分析手术和美学效果。

方法

这项回顾性研究纳入了172例行OBCS并即刻进行基于ADM的容积替代的乳腺癌患者（2020年至2022年）。患者接受了微粒ADM联合片状ADM（n = 102）或微粒ADM联合糊状ADM（n = 70）。术后6个月、12个月和24个月使用MRI评估ADM容积。

结果

两组均实现了长期容积稳定性，24个月时容积减少最小（4.3% - 4.5%）（P < 0.001）。早期手术并发症包括血肿（4.1%）、血清肿（2.3%）和伤口问题（1.2%），无感染或ADM未整合情况。16.3%的病例出现外形不规则。放疗（87%的患者）对ADM容积保留无显著影响。

结论

ADM在OBCS中提供了可预测、持久的容积替代，即使在放疗情况下也具有出色的容积稳定性。这种对ADM容积保留长达两年的定量评估支持ADM作为保乳手术的可靠选择，可能为肿瘤与乳房容积比不利的患者扩大治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/469c5d1c2091/jcm-14-03002-g006a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/2280190fd999/jcm-14-03002-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/1022462768a7/jcm-14-03002-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/9da66f340a69/jcm-14-03002-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/22f949622107/jcm-14-03002-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/f656c4bf5b5a/jcm-14-03002-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/469c5d1c2091/jcm-14-03002-g006a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/2280190fd999/jcm-14-03002-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/1022462768a7/jcm-14-03002-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/9da66f340a69/jcm-14-03002-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/22f949622107/jcm-14-03002-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/f656c4bf5b5a/jcm-14-03002-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f27e/12072617/469c5d1c2091/jcm-14-03002-g006a.jpg

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本文引用的文献

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Cancers (Basel). 2025 Apr 11;17(8):1293. doi: 10.3390/cancers17081293.
2
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BMC Surg. 2025 Mar 5;25(1):91. doi: 10.1186/s12893-025-02821-z.
3
Volume replacement in tumor plastic surgery and breast-conserving surgery using 3D grid and strip‑shaped acellular dermal matrix: Two case reports.
使用3D网格和条形脱细胞真皮基质进行肿瘤整形手术和保乳手术中的容量替代：两例病例报告。
Exp Ther Med. 2024 Jul 16;28(3):366. doi: 10.3892/etm.2024.12655. eCollection 2024 Sep.
4
Impact of Adjuvant Radiotherapy on Free Flap Volume in Autologous Breast Reconstruction: A Scoping Review.辅助放疗对自体乳房重建中游离皮瓣体积的影响：一项范围综述。
J Clin Med. 2023 Dec 29;13(1):217. doi: 10.3390/jcm13010217.
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Predictors of Lumpectomy Size after Breast-Conserving Surgery in Patients with Breast Cancer: A Retrospective Cohort Study.保乳手术后乳腺癌患者保乳手术范围的预测因素：一项回顾性队列研究。
Plast Reconstr Surg. 2024 Sep 1;154(3):503-510. doi: 10.1097/PRS.0000000000011085. Epub 2023 Sep 26.
6
Review of 107 Oncoplastic Surgeries Using an Acellular Dermal Matrix with the Round Block Technique.使用圆形阻滞技术联合脱细胞真皮基质进行107例肿瘤整形手术的回顾。
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