Hardt N S, Yu L, LaTorre G, Steinbach B
Department of Pathology, University of Florida College of Medicine, Gainesville.
Plast Reconstr Surg. 1995 Feb;95(2):364-71. doi: 10.1097/00006534-199502000-00017.
Citing evidence that breast implant-related capsules resolve uneventfully, surgeons have elected to leave the capsules in place when implants are removed because capsulectomy adds both morbidity and expense to the procedure. However, recent clinical and histopathologic evidence suggests that uneventful resolution is not always the case, and several potential problems may arise from retained capsules after removal of the implant. Retained implant capsules may result in a spiculated mass suspicious for carcinoma, dense calcifications that obscure neighboring breast tissue on subsequent imaging studies, and cystic masses due to persistent serous effusion, expansile hematoma, or encapsulated silicone filled cysts. Furthermore, retained capsules are a reservoir of implant-related foreign material in the case of silicone gel-filled implants and textured implants promoting tissue ingrowth. To avoid complications from retained capsules, total capsulectomy or postoperative surveillance should be offered to patients.
引用与乳房植入物相关的包膜可顺利消退的证据，外科医生在移除植入物时选择保留包膜，因为包膜切除术会增加手术的发病率和费用。然而，最近的临床和组织病理学证据表明，并非总是能顺利消退，移除植入物后保留的包膜可能会引发几个潜在问题。保留的植入物包膜可能会导致出现可疑为癌的毛刺状肿块、在后续影像学检查中使邻近乳腺组织模糊不清的致密钙化，以及因持续浆液性渗出、扩展性血肿或包膜内硅凝胶填充囊肿导致的囊性肿块。此外，对于硅胶填充植入物和促进组织向内生长的带纹理植入物而言，保留的包膜是植入物相关异物的储存库。为避免保留包膜引发并发症，应向患者提供全包膜切除术或术后监测。
