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三平面技术:一种基于胸肌下植入物的乳房重建手术技术。

The triple-plane technique: a surgical technique for subpectoral implant-based breast reconstruction.

作者信息

He Yue, He Wenfei, Xia Mingzhi, Liu Zhihua, Zhu Zhaoyang, Andersen Frederik Thørholm, Piccolo Paulo P, Yeap Isobel, Hwee Jolie Jingyi, Wu Zhaoyun, Hu Xiaobo

机构信息

Department of Breast Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.

Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Gland Surg. 2025 May 30;14(5):958-967. doi: 10.21037/gs-2025-116. Epub 2025 May 27.


DOI:10.21037/gs-2025-116
PMID:40546844
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12177546/
Abstract

Breast reconstruction surgery is an important part of breast cancer treatment. However, implant-based breast reconstruction is associated with a number of complications, such as infection, seroma, prosthesis exposure, and skin erythema. In this study, we propose a novel surgical technique for implant-based breast reconstruction-the triple-plane technique. This technique positions the prosthesis in a complete submuscular plane. Medially, it is subpectoral, and inferolaterally it is covered by a flap of serratus anterior and latissimus dorsi fascia. As such, the prosthesis is not in contact with the skin, thereby reducing postoperative complications. This article reports on the breast reconstruction results of 96 breast cancer patients who underwent unilateral breast reconstruction surgery using the triple-plane technique at Hunan Cancer Hospital. The results show that breast appearance after surgery was rated as excellent by 92 (95.83%) patients, and good by 4 (4.17%) patients. The average operation time, surgical incision, intraoperative blood loss, and hospitalization time of patients were 88.40±12.13 minutes, 12.24±4.01 cm, 46.40±10.73 mL, and 7.23±1.00 days, respectively. Skin necrosis at the edge of the incision was observed in 1 (1.04%) patient, which healed normally after debridement and closure. The scores of BREAST-Q patient-reported outcome measure ranged from 80 to 100 points for all of the patients. These results demonstrate that the triple-plane technique offers a novel and safe technique for breast reconstruction surgery.

摘要

乳房重建手术是乳腺癌治疗的重要组成部分。然而,基于植入物的乳房重建会引发多种并发症,如感染、血清肿、假体暴露和皮肤红斑。在本研究中,我们提出了一种用于基于植入物乳房重建的新型手术技术——三平面技术。该技术将假体置于完全的肌下平面。在内侧,它位于胸大肌下,在外侧下则由前锯肌和背阔肌筋膜瓣覆盖。这样一来,假体不与皮肤接触,从而减少术后并发症。本文报告了96例在湖南省肿瘤医院接受三平面技术单侧乳房重建手术的乳腺癌患者的乳房重建结果。结果显示,术后乳房外观被92例(95.83%)患者评为优秀,4例(4.17%)患者评为良好。患者的平均手术时间、手术切口、术中出血量和住院时间分别为88.40±12.13分钟、12.24±4.01厘米、46.40±10.73毫升和7.23±1.00天。1例(1.04%)患者在切口边缘出现皮肤坏死,经清创缝合后正常愈合。所有患者的BREAST-Q患者报告结局量表得分在80至100分之间。这些结果表明,三平面技术为乳房重建手术提供了一种新颖且安全的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/ff5741c5e90a/gs-14-05-958-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/a1237bb18de3/gs-14-05-958-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/fc8b8d372f54/gs-14-05-958-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/21fbc9d9be3d/gs-14-05-958-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/ff5741c5e90a/gs-14-05-958-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/a1237bb18de3/gs-14-05-958-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/fc8b8d372f54/gs-14-05-958-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/21fbc9d9be3d/gs-14-05-958-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9bb/12177546/ff5741c5e90a/gs-14-05-958-f4.jpg

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本文引用的文献

[1]
Postoperative outcomes of minimally invasive versus conventional nipple-sparing mastectomy with prosthesis breast reconstruction in breast cancer: a meta-analysis.

J Robot Surg. 2024-6-29

[2]
Single versus Double Drainage for Immediate Two-Stage Implant-Based Breast Reconstruction: A Propensity Score-Matched Analysis.

Aesthetic Plast Surg. 2024-9

[3]
Comparative clinical outcomes of using three-dimensional and TIGR mesh in immediate breast reconstruction surgery for breast cancer patients.

J Plast Reconstr Aesthet Surg. 2023-11

[4]
Implant Based Breast Reconstruction Using a Titanium-Coated Polypropylene Mesh (TiLOOP® Bra): A Systematic Review and Meta-analysis.

Aesthetic Plast Surg. 2024-3

[5]
Immediate Breast Reconstruction Using the Autologous Dermal Flap.

J Surg Res. 2023-3

[6]
The Relationship Between Neuropsychiatric Diagnoses and Revision Surgery After Breast Reconstruction.

Ann Plast Surg. 2022-12-1

[7]
A Bayesian Network Meta-Analysis of Complications Related to Breast Reconstruction Using Different Skin Flaps After Breast Cancer Surgery.

Aesthetic Plast Surg. 2022-8

[8]
Systematic Review of Breast-Q: A Tool to Evaluate Post-Mastectomy Breast Reconstruction.

Breast Cancer (Dove Med Press). 2021-12-16

[9]
The Impact of implant-based reconstruction on persistent pain after breast cancer surgery: A systematic review.

J Plast Reconstr Aesthet Surg. 2022-2

[10]
Implant infections after breast reconstruction surgery following mastectomy: Experience from a Greek breast unit.

Breast Dis. 2022

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