文章：

术前胸肌前与胸肌下植入物即刻乳房重建的术后效果比较

Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction

原文发布日期：12 March 2024

DOI: 10.3390/cancers16061129

类型: Article

开放获取: 是

英文摘要：

Introduction: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. Methods: We analyzed all complications and grade 2–3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR. Results: Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR (p= 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2–3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2–3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2–3 complications. Conclusions: Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique.

摘要翻译： 

引言：即刻乳房重建技术正快速发展。本研究比较了单中心假体植入即刻乳房重建队列中胸肌下与胸肌前假体植入（无论是否使用补片）的临床结果。方法：通过对比胸肌下与胸肌前假体植入即刻乳房重建，我们分析了所有并发症及2-3级并发症发生率、假体丢失率、手术时长、住院时间、患者满意度、辅助治疗间隔时间及治疗成本。结果：529例乳房切除术（62.0%）采用胸肌下假体植入重建，324例采用胸肌前植入，近年来胸肌前植入比例显著增加。176例胸肌前植入（54.3%）使用了补片。共147例乳房切除术（17.2%）报告了各级并发症，其中胸肌前假体植入组的并发症发生率显著更高（p=0.036）。回归分析显示胸肌前植入与各级并发症及2-3级并发症无显著相关性。胸肌前假体植入重建的手术时间显著缩短，住院时间显著减少。2-3级并发症与患者满意度降低显著相关。更高成本与胸肌下植入及补片使用显著相关。并发症风险预测评分识别出五个2-3级并发症显著升高的风险组。结论：随时间推移胸肌前补片即刻乳房重建应用增加，其并发症发生率与胸肌下补片即刻乳房重建无显著差异。胸肌前假体植入可被视为一种安全的技术。

原文链接：

Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction