Predictive Factors of Capsular Contracture in Prepectoral Direct-to-Implant Breast Reconstruction and its Surgical Approach.

IF 1.3 Q3 SURGERY
Archives of Plastic Surgery-APS Pub Date : 2025-03-11 eCollection Date: 2025-03-01 DOI:10.1055/a-2505-7591
Si Youn Kim, Se Won Oh, Eun Jung Yang, Seung Yong Song, Dong Won Lee
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Abstract

Background  Prepectoral direct-to-implant (DTI) is a common implant-based breast reconstruction method used for patients with breast cancer, although patients often present capsular contracture as a common complication. This study aimed to investigate the causes and surgical outcomes of capsular contractures in patients with breast cancer who underwent prepectoral DTI. Methods  The medical records of 392 patients (472 breasts) who underwent prepectoral DTI between August 2019 and July 2022 were retrospectively reviewed. Comparative and multivariate analyses were performed to identify risk factors for capsular contracture. The outcomes of patients who underwent surgical procedures were analyzed. Results  Of the 472 breasts enrolled in the study, 47 (9.9%) showed capsular contracture. Multivariate analysis revealed that patient age, seroma, rippling, and postmastectomy radiotherapy were independent correlating factors for capsular contracture in prepectoral DTI. Partial capsulectomy was performed on 18 breasts with capsular contracture, which resolved in 88.9% of cases. The mean follow-up period was 14.4 months. Conclusion  Age, seroma, rippling, and radiotherapy were independent correlating factors for capsular contracture in prepectoral DTI. Further, partial capsulectomy is recommended as a treatment option to improve results. A better understanding of the causes and surgical outcomes of capsular contracture on prepectoral DTI will help reduce capsular contracture and eventually lead to better outcomes in breast cancer reconstruction.

乳前直接植入乳房重建术中包膜挛缩的预测因素及手术入路。
背景:乳房前膜直接植入(DTI)是一种常见的基于假体的乳房重建方法,用于乳腺癌患者,尽管患者经常出现包膜挛缩作为常见的并发症。本研究旨在探讨乳腺癌患者行孕前DTI的包膜挛缩的原因和手术结果。方法回顾性分析2019年8月至2022年7月392例(472个乳房)产前DTI患者的病历。进行了比较和多因素分析,以确定包膜挛缩的危险因素。分析了接受外科手术的患者的预后。结果纳入研究的472个乳房中,有47个(9.9%)乳房出现包膜挛缩。多因素分析显示,患者年龄、血清肿、涟漪和乳房切除术后放疗是乳房前DTI包膜挛缩的独立相关因素。对18例包膜挛缩的乳房行部分包膜切除术,治愈率达88.9%。平均随访14.4个月。结论年龄、血肿、波纹、放疗是膀胱前侧DTI包膜挛缩的独立相关因素。此外,部分荚膜切除术被推荐作为改善结果的治疗选择。更好地了解乳腺前DTI包膜挛缩的原因和手术效果,有助于减少包膜挛缩,最终获得更好的乳腺癌重建效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
6.70%
发文量
131
审稿时长
10 weeks
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