Single-Surgeon Experience for Maximizing Outcomes in Implant-Based Breast Reconstruction in Chinese Patients
Single-Surgeon Experience for Maximizing Outcomes in Implant-Based Breast Reconstruction in Chinese Patients
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单一外科医生经验可最大程度地提高中国患者植入式乳房重建的效果
DOI：
10.1097/sap.0000000000001645
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发表时间：
2019-03
影响因子：
1.5
通讯作者：
Yin Zhuming
中科院分区：
文献类型：
--
作者：
He Shanshan;Yin Jian;Sun Jingyan;Huang Qingfeng;Liu Jing;Han Chunyong;Yin Zhuming
在中国，由于文化差异、患者偏好、资源获取和保险范围等因素，乳房重建在中国患者中的应用存在很大差异。考虑到这些独特的因素，应该考虑一种不同的方法来优化结果。方法回顾性分析2013年1月至2016年5月接受假体乳房再造术的患者。术后至少6个月由患者和1名非手术外科医生进行美学评估，并使用Breast-Q评估患者满意度。结果共回顾了135例接受141例假体乳房重建的患者。大多数植入物（n = 134）放置在胸下位置，而7放置在胸前位置，没有使用脱细胞真皮基质。考虑到脱细胞真皮基质使用的局限性，局部区域皮瓣增加了软组织覆盖。94例（66.7%）使用背阔肌重建，39例（27.7%）使用前锯肌重建，7例（5.0%）仅使用乳房切除术皮瓣覆盖种植体。4例（2.8%）患者接受了重建乳房的翻修手术。III级和IV级包膜挛缩分别在10例（7.1%）和2例（1.4%）重建中观察到。患者和外科医生对乳房对称的满意度均高于80%。结论该方法符合中国人群特点，可推广应用于不同类型的乳房再造术。它产生了良好的美学效果，并且在临床环境中具有可重复性、可预测性和易于掌握的特点。
Introduction Breast reconstruction for Chinese patients is vastly different given cultural differences, patient preferences, access to resources, and insurance coverage in China. Given these unique factors, a different approach for optimizing outcomes should be considered. Methods Retrospective review of all patients undergoing implant-based breast reconstruction from January 2013 to May 2016 was performed. Esthetic evaluations were made both by the patients and 1 nonoperative surgeon at least 6 months postoperative, and patient satisfaction was assessed using the Breast-Q. Results Overall, 135 patients undergoing 141 implant-based breast reconstructions were reviewed. The majority of implants (n = 134) were placed in a subpectoral position, whereas 7 were placed prepectorally, and no acellular dermal matrix was used. Given the limitations in acellular dermal matrix usage, soft-tissue coverage was augmented with local regional flaps. Ninety-four reconstructions (66.7%) used latissimus dorsi, 39 (27.7%) used serratus anterior, and 7 (5.0%) used mastectomy skin flaps only for implant coverage. Four patients (2.8%) underwent revision surgery to the reconstructed breasts. Grade III and grade IV capsular contracture was observed in 10 (7.1%) and 2 (1.4%) reconstructions, respectively. Both the patient's and the surgeon's satisfaction were higher than 80% in breast symmetry. Conclusions Our implant selection method fit the Chinese population characteristics and could be extended to different types of implant-based breast reconstruction. It produced good esthetic outcomes and was reproducible, predictable, and simple to master in the clinical setting.
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影响因子：
3.9
作者：
Brennan, Meagan E.;Flitcroft, Kathy;Spillane, Andrew J.
通讯作者：
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作者：
I. C. Aguiar;D. Veiga;Thaline Figueiredo Marques;N. Novo;M. Sabino Neto;L. Ferreira
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DOI：
10.1016/s1535-1513(09)79473-1
发表时间：
2011
期刊：
Yearbook of Plastic and Aesthetic Surgery
影响因子：
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作者：
R. Ruberg
通讯作者：
R. Ruberg
DOI：
10.1016/j.bjps.2011.12.040
发表时间：
2012-07
期刊：
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
影响因子：
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作者：
N. Singh;N. Reaven;S. Funk
通讯作者：
N. Singh;N. Reaven;S. Funk