立即混合乳房重建:双平面方法使用乳房前植入物和倒乳脂肪移植。

IF 3.4 2区 医学 Q1 SURGERY
Plastic and reconstructive surgery Pub Date : 2025-08-01 Epub Date: 2025-01-22 DOI:10.1097/PRS.0000000000011984
Benedetto Longo, Martina Giacalone, Gennaro D'Orsi, Alessio Farcomeni, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Claudio Oreste Buonomo, Valerio Cervelli
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引用次数: 0

摘要

背景:以假体为基础的乳房重建(BR)是迄今为止最流行的重建方式。本研究的目的是评估双平面入路即刻混合一期BR技术,使用胸前植入物和逆行直肠自体脂肪移植(AFT)。方法:作者前瞻性地招募了使用混合入路计划立即BR的患者,其中包括逆行AFT和胸前植入物(a组)。该队列与回顾性对照组(B组)进行比较,B组患者接受了即刻直接植入体BR而不进行AFT。分析并发症、住院天数、完整BR的AFT手术次数、美学结果和患者满意度。通过比较术前和术后6个月的MRI扫描来评估脂肪存活率。结果:两组共30例即刻br。B组逆行位平均AFT量为106.30 cc (SD, 16.54),假体平均尺寸显著高于B组(P = 0.00026)。MRI评估证实术后6个月逆行性脂肪平均生存率为47.90% (SD, 0.14%)。并发症和住院天数方面差异无统计学意义(P < 0.05),而额外AFT治疗方面差异有统计学意义(P = 0.00062)。经过倾向评分加权分析,外科医生和患者的评估显示,积极组的总体满意度明显更高。结论:一期BR的即时混合入路可以使用更小的乳房植入物,减少AFT手术的成本,并通过减少台阶畸形和波纹改变获得最佳的乳房形状和轮廓,而不会增加并发症。临床问题/证据水平:治疗性,III。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immediate Hybrid Breast Reconstruction: Dual-Plane Approach Using Prepectoral Implants and Retropectoral Fat Grafting.

Background: Implant-based breast reconstruction (BR) is to date the most popular reconstructive modality. The aim of the study was to evaluate the immediate hybrid 1-stage BR technique, with a dual-plane approach, using prepectoral implants and retropectoral autologous fat transfer (AFT).

Methods: The autthors prospectively enrolled patients scheduled for immediate BR using a hybrid approach, which included retropectoral AFT and prepectoral breast implants (group A). This cohort was compared with a retrospective control group of patients who underwent immediate direct-to-implant BR without AFT (group B). Complications, hospitalization days, number of AFT procedures for a complete BR, aesthetic outcomes, and patient satisfaction were analyzed. Fat suuvival rate was assessed through comparison of preoperative and 6-month postoperative MRI scans.

Results: Thirty immediate BRs were included in each group. The average amount of AFT in the retropectoral plane was 106.30 cc (SD, 16.54), and the mean breast implant size was statistically higher in group B (P = 0.00026). MRI assessment confirmed an average of 47.90% (SD, 0.14%) retropectoral fat survival at 6 months postoperatively. No statistically significant differences in terms of complications and hospitalization days were observed (P > 0.05), whereas a significant difference was observed regarding additional AFT sessions (P = 0.00062). After a propensity score-weighted analysis, assessment by surgeons and patients showed a significantly higher overall satisfaction in the active group.

Conclusion: The immediate hybrid approach for 1-stage BR enabled the use of smaller breast implants, allowed a decrease in AFT procedures with costs reduction, and yielded optimal breast shape and contour by reducing stepoff deformity and rippling alterations, without adding complications.

Clinical question/level of evidence: Therapeutic, III.

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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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