Evans A A, Straker V F, Rainsbury R M
Breast Unit, Royal Hampshire County Hospital, Winchester, UK.
J R Soc Med. 1993 Nov;86(11):630-3.
Breast reconstruction is normally carried out by plastic surgeons, but the advent of permanent tissue expanders places post-mastectomy reconstruction within easy reach of the general surgeon. Nineteen patients underwent breast reconstruction between 1989 and 1991 using a subpectoral silicone-based, double lumen tissue expander. Assessment of results was by: (a) patient completed questionnaire; and (b) third party evaluation of standardized photographs. The mean operating time was 58 min (40-80 min) and mean hospital stay 3 days (2-7 days). Complications included one flap necrosis and one leaking injection port. Outpatient tissue expansion required an average of seven visits (4-11) and was completed in an average of 12 months (7-19). The injection port was subsequently removed under local anaesthetic as a day case. The fully dressed appearance following reconstruction was graded good or excellent by 100% of patients and in over 80% of third-party assessments. Equivalent figures for the appearance when wearing a bra were 93% and 60% and undressed 57% and 47%, respectively. All patients recommended the procedure but 25% found inflation uncomfortable. Subpectoral tissue expansion is a safe, cosmetically acceptable method of breast reconstruction which is associated with a high level of patient satisfaction.
乳房重建通常由整形外科医生进行，但永久性组织扩张器的出现使乳房切除术后的重建变得普通外科医生也容易做到。1989年至1991年间，19例患者使用了基于硅胶的胸肌下双腔组织扩张器进行乳房重建。结果评估通过以下方式进行：(a)患者填写问卷；(b)第三方对标准化照片进行评估。平均手术时间为58分钟（40 - 80分钟），平均住院时间为3天（2 - 7天）。并发症包括1例皮瓣坏死和1例注射端口渗漏。门诊组织扩张平均需要7次就诊（4 - 11次），平均在12个月（7 - 19个月）内完成。随后在局部麻醉下作为日间手术切除注射端口。重建后着装后的外观在100%的患者和超过80%的第三方评估中被评为良好或优秀。穿着胸罩时外观的相应数字分别为93%和60%，裸体时为57%和47%。所有患者都推荐该手术，但25%的患者觉得扩张过程不舒服。胸肌下组织扩张是一种安全、美容效果可接受的乳房重建方法，患者满意度较高。
