乳房胸肌前假体重建的复兴:理论依据及研究现状  

Renaissance of prepectoral implant-based breast reconstruction: theoretical basis and research status

作　　者：林炜怡 陈洁[1] 谭秋雯 LIN Weiyi;CHEN Jie;TAN Qiuwen(Department of Breast Surgery,Clinical Center for Breast,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)

机构地区：[1]四川大学华西医院乳腺疾病中心,成都610041

出　　处：《中国修复重建外科杂志》2023年第2期233-239,共7页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 对近期乳房假体重建的热门术式——乳房胸肌前假体重建的理论依据及研究现状进行综述。方法 查阅近年国内外关于胸肌前平面假体植入在乳房重建中应用的相关研究,分析乳房胸肌前假体重建复兴的理论依据、临床应用现状及局限性,探讨该领域发展趋势。结果 乳腺肿瘤生物学研究进展、材料学及肿瘤整形理念的发展是乳房胸肌前假体重建复兴的重要理论基础。患者选择及术者经验是胸肌前假体重建复兴获得良好疗效的重要前提,理想的皮瓣厚度和血运是选择该术式最重要考量因素。然而,该术式长期重建效果及在亚洲人群的临床获益、风险仍需更多研究明确。结论 乳房胸肌前假体重建具有广阔应用前景,但目前证据有限,缺乏随机、大样本长期随访的研究,以获取足够证据评估乳房胸肌前假体重建的安全性及可靠性。Objective To overview the theoretical basis and research status of prepectoral implant-based breast reconstruction. Methods The domestic and foreign researches on the application of prepectoral implant-based breast reconstruction in breast reconstruction were retrospectively analyzed. The theoretical basis, clinical advantages, and limitations of this technique were summarized and the future development trend in this field was discussed. Results The recent advances in breast cancer oncology, the development of materials and the concept of oncology reconstruction have provided a theoretical basis for prepectoral implant-based breast reconstruction. The selection of patients and the experience of surgeons are crucial for postoperative outcomes. Ideal thickness and blood flow of flaps are the most important considerations for the selection of prepectoral implant-based breast reconstruction. However, its long-term reconstruction outcomes and clinical benefits and risks in Asian populations still need to be confirmed by more studies.Conclusion Prepectoral implant-based breast reconstruction has a broad application prospect in breast reconstruction following mastectomy. However, the evidence is limited at present. Randomized study with long-term follow-up is urgently in need to provide sufficient evidence to evaluate the safety and reliability of prepectoral implant-based breast reconstruction.

关 键 词：乳房假体重建 胸肌前平面 脱细胞真皮基质 乳腺癌 

分 类 号：R655.8[医药卫生—外科学]