Archives of Plastic Surgery

  • 제39권3호
  • /
  • Pages.216-221
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  • 2012
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Recipient Vessel Selection in Immediate Breast Reconstruction with Free Abdominal Tissue Transfer after Nipple-Sparing Mastectomy

  • Yang, Sung-Jun (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Eom, Jin-Sup (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Taik-Jong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Sei-Hyun (Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Son, Byung-Ho (Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.02.13
  • 심사 : 2012.04.25
  • 발행 : 2012.05.15
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초록

Background : Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Methods : Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Results : Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. Conclusions : The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

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참고문헌

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피인용 문헌

  1. Breast Reconstruction following Nipple-Sparing Mastectomy: A Systematic Review of the Literature with Pooled Analysis vol.132, pp.5, 2012, https://doi.org/10.1097/prs.0b013e3182a48b8a
  2. Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques vol.5, pp.3, 2014, https://doi.org/10.5306/wjco.v5.i3.478
  3. Necrotic Complications in Nipple-Sparing Mastectomy Followed by Immediate Breast Reconstruction: Systematic Review with Pooled Analysis vol.23, pp.2, 2012, https://doi.org/10.15596/arms.2014.23.2.51
  4. The Oncological Safety of Nipple-Sparing Mastectomy: A Systematic Review of the Literature with a Pooled Analysis of 12,358 Procedures vol.43, pp.4, 2016, https://doi.org/10.5999/aps.2016.43.4.328
  5. Comparison of Outcomes with Tissue Expander, Immediate Implant, and Autologous Breast Reconstruction in Greater Than 1000 Nipple-Sparing Mastectomies vol.139, pp.6, 2017, https://doi.org/10.1097/prs.0000000000003340
  6. Comparing the thoracodorsal and internal mammary vessels as recipients for microsurgical autologous breast reconstruction: A systematic review and meta‐analysis vol.37, pp.8, 2017, https://doi.org/10.1002/micr.30244
  7. Examining Length of Hospital Stay after Microsurgical Breast Reconstruction: Evaluation in a Case-Control Study vol.5, pp.12, 2012, https://doi.org/10.1097/gox.0000000000001588
  8. Skin-sparing Mastectomy and Immediate Nipple Graft for Large, Ptotic Breast vol.22, pp.4, 2012, https://doi.org/10.4048/jbc.2019.22.e52
  9. Choice of recipient vessels in muscle-sparing transverse rectus abdominis myocutaneous flap breast reconstruction: A comparative study vol.46, pp.2, 2012, https://doi.org/10.5999/aps.2018.00913
  10. Revisiting the internal mammaries as recipient vessels in breast reconstruction: considerations in current practice vol.184, pp.2, 2012, https://doi.org/10.1007/s10549-020-05878-x