保留乳头的金凤花乳房切除术——对原有技术的新改良。

Ahmed Setit, Khaled Bela, Ashraf Khater, Islam Elzahaby, Amr Hossam, Emad Hamed
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引用次数: 0

摘要

目的:虽然金凤花乳房切除术具有良好的美容效果。乳头-乳晕复合体(NAC)的切除通常会产生负面的心理影响。本研究的目的是评估使用真皮蒂挽救NAC的可行性和美学结果。材料与方法:研究对象为女性乳腺癌伴大乳或上睑下垂患者。患者接受金凤花乳房切除术。那些不适合麻醉的人,那些局部晚期或转移性疾病的人或拒绝手术的人被排除在外。结果:女性患者15例(18个乳房),平均年龄51.6岁,行金凤花乳房再造术并进行NAC保存试验。平均体重指数为39.1 kg/m2。半数以上(56%)为C杯,44%为d杯,7例(46.7%)为II级,8例(53.3%)为III级。平均手术时间168分钟(130 ~ 240分钟)。NAC缺血性改变5例;2例(11%)为部分,3例(17%)为全部。2例(11%)皮瓣缺损,1例为全皮瓣缺损。未见局部复发或远处转移。结论:保留乳头的金凤花乳房切除术对于某些大乳房和(或)上睑下垂患者是一种有吸引力和可行的选择。然而,这是一项耗时的技术,皮瓣和NAC并发症的发生率相对较高。此外,还需要对更多的病例和更长时间的随访进行研究。
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Nipple Sparing Goldilocks Mastectomy, A New Modification of the Original Technique.

Objective: Although Goldilocks mastectomy offers good aesthetic outcomes. Removal of the nipple-areolar complex (NAC) often has a negative psychological impact. The objective of this study was to assess the feasibility and esthetic outcome of this technique with salvage of the NAC using a dermal pedicle.

Materials and methods: The study included female patients suffering from breast carcinoma with large and or ptotic breast. Patients were offered Goldilocks mastectomy. Those who were unfit for anesthesia, those with locally advanced or metastatic disease or those refusing the procedure were excluded.

Results: Fifteen female patients (18 breasts) with a mean age of 51.6 years underwent Goldilocks breast reconstruction with a trial of NAC preservation. The mean body mass index was 39.1 kg/m2. More than half (56%) were cup C, while 44% were cup D. Seven cases (46.7%) showed grade II ptosis and 8 (53.3%) were grade III. The mean operative time was 168 minutes (range 130-240 minutes). NAC ischemic changes were noted in five cases; two (11%) were partial while three (17%) were total. Two cases (11%) suffered from flap loss and one of them was total. No locoregional recurrence or distant metastases were observed.

Conclusion: The Goldilocks mastectomy with nipple preservation is an appealing and feasible option for a certain group of patients who have large-sized and/or ptotic breasts. Nevertheless, it is a time-consuming technique with relatively higher rates of flap and NAC complications. Further, studies are required with a larger number of cases and longer follow-up.

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