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Risk-Reducing Surgery By Skin-Sparing Mastectomy (Ssm) And Immediate Implant-Based Reconstruction With And Without Titanized Meshes And Quality Of Life.

JOURNAL OF CLINICAL ONCOLOGY(2012)

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摘要
48 Background: The impact of risk-reducing surgery with skin sparing mastectomy and immediate reconstruction on quality of life using new textured implants and titanized meshes (Tiloop bra) has not beed evaluated by standardized quality of life questionnaires (EORTC) with regards to surgery-related morbidity and patients' satisfaction.This large case cohort trial (n=197) evaluates safety, aesthetic outcome and patient's satisfaction with immediate reconstruction with and without the use of titanized a mesh versus a corial flap after SSM.This large retrospective case cohort trial analysed 197 skin sparing mastectomies (SSM) in 161 patients (45 bilateral cases) and immediate breast reconstruction (IBR). We used a double-plane technique covering the implant by the submuscular pouch in its cranial half and a corial-fat-flap or titanized mesh (Tiloop bra) for covering its lower pole or a de-epithelized corial flap in breasts with macromastia following an inferior-pedicled reduction mammaplasty pattern according to Ribeiro in the modification of Rezai.163 women, with a median age of 41 years, with a total of 197 SSMs were evaluated. The majority did not experience pain and expressed satisfaction with volume, symmetry, aesthesis and quality of life in general. Partner interaction after breast reconstruction was normal. The use of titanized meshes was perceived as favourable with regards to better fitting of the breast in the bra and clothing and yielded low complication rates. The rating of patients in terms of self-perception after the reconstruction was good. Immediate reconstruction has a significant positive impact and gives the patient a considerable physical and psychological support.The oncological safety of the method is high with 2 recurrences only in this cohort of 163 women (1.2% ) and a follow-up of up to 6 years.
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关键词
mastectomy,titanized meshes,surgery,reconstruction,risk-reducing,skin-sparing,implant-based
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