皮瓣厚度对放疗患者不使用 ADM 的胸前乳房再造主要并发症的影响

IF 0.7 4区 医学 Q4 SURGERY
Zeynep Altuntaş, Moath Zuhour, Orkun Uyanık
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引用次数: 0

摘要

目的:最近的研究开始质疑在植入假体的胸大肌前乳房即刻重建中使用非细胞真皮基质(ADM)的必要性。然而,这些研究中的大多数患者并没有接受术后放疗。本研究旨在调查不使用 ADM 的即刻胸大肌前乳房重建术后的主要并发症发生率,并找出乳房切除皮瓣厚度的最佳临界值。方法这项回顾性研究纳入了 2020 年至 2022 年期间接受即刻胸前乳房重建术并接受术后放疗的患者。研究了乳房切除皮瓣厚度与主要并发症之间的相关性。研究结果本研究共纳入 77 例患者,对应 81 个乳房。18个乳房(22%)出现了主要并发症。乳房切除皮瓣的厚度从 0.31 毫米到 1.2 厘米不等,平均厚度为 6.6 ± 2.1 毫米。在随访期间(21.1 ± 4.3 M),所有患者均未出现囊挛缩。皮瓣厚度≤5.5毫米是将接受放疗的患者出现主要并发症的临界值(P < .05)。结论不使用 ADM 的即刻胸前乳房重建是一种可靠、安全的乳房重建方法。但是,如果计划进行放射治疗,当乳房切除皮瓣厚度等于或低于 5.5 毫米时,必须小心谨慎,以避免出现重大并发症。采用横向乳房切除切口的胸前乳房再造术能够以较高的成本效益一次性完成乳房再造。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Flap Thickness on Major Complications of Prepectoral Breast Reconstruction Without Using ADM in Radiotherapy Patients
Objectives: Recent studies have started to question the need for acellular dermal matrix (ADM) in immediate implant-based prepectoral breast reconstruction. However, most of the patients in these studies did not receive postoperative radiotherapy. In this study, it was aimed to investigate the major complication rate after immediate prepectoral breast reconstruction without the use of ADM and to find the optimal cutoff value of the mastectomy flap thickness. Methods: Patients who underwent immediate prepectoral breast reconstruction and received postoperative radiotherapy between 2020 and 2022 were included in this retrospective study. The correlation between mastectomy flap thickness and major complications was investigated. Results: A total of 77 patients, corresponding to 81 breasts were included in this study. Major complications were encountered in 18 (22%) breasts. The thickness of mastectomy flaps ranged from 0.31 mm to 1.2 cm, with an average thickness of 6.6 ± 2.1 mm. No capsule contracture was encountered in any of the patients during the follow-up period (21.1 ± 4.3 M). A flap thickness of ≤5.5 mm is the cutoff value for developing major complications in patients who will receive radiotherapy ( P < .05). Conclusion: Immediate prepectoral breast reconstruction without using ADM is a reliable and safe method for breast reconstruction. However, if radiotherapy is planned, care must be taken when mastectomy flap thickness is equal or below 5.5 mm to avoid major complications. Prepectoral reconstruction with transverse mastectomy incision provides the ability to complete the reconstruction in a single session with a high cost-effective way.
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来源期刊
Plastic surgery
Plastic surgery Medicine-Surgery
CiteScore
1.70
自引率
0.00%
发文量
73
期刊介绍: Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.
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