IMPLANT-BASED BREAST CANCER RECONSTRUCTION WITH BIOLOGICAL MATRIC OR SYNTHETIC MESH
Introduction. In the recent years, considerable progress is achieved in the combination treatment of breast cancer (BC). Reconstructive-plastic surgery occupies the main place in rehabilitation of BC patients and is considered now as etiotropic treatment of mental disorders associated with the loss of feminity and continuity of organ. At the immediate breast cancer reconstruction, it becomes urgent to use additional materials: synthetic and biological implants capable of replacing muscular autotransplantats. The use of these materials allows minimization № 2 (61) июнь’2017 Вопросы реконструктивной и пластической хирургии Пластическая хирургия 25 of injury, blood loss, and surgery time, as well as assumes no defects of donor zones. The paper presents the review of publications and results obtained by the authors. Material and methods. Since 2013 till 2016, specialists of the P. Herzen Moscow Oncology Research Institute made 104 one-time breast cancer reconstructions with the use of mesh implants in 80 cases, acellular dermal matrix in 24 cases after radical skin-sparing or subcutaneous mastectomy. Average age of patients was 47.2 years. Stage 0 breast cancer was diagnosed in 2% of cases, I - 30%, IIA - 33%, IIB - 16%, IIIA - 15%, IIIB - 2%, IIIC - 2%. Titanium mesh implants were used in 12 patients, and polyester 3D mesh implants were applied in 68 cases. The size of silicone implants varied from 120 to 585 cm3 depended on anatomic features of chest wall and breast constitution. Results. Cosmetic results were considered as excellent in 67.3% of cases, good in 19.2% of cases, satisfactory in 7.7% of cases, and poor in 5.8% of cases. The frequency of removal of silicone implant was 5.8% when titanium mesh implant was used and 0% for the polyester 3D mesh implant. Seroma was diagnosed in 1.9% of cases with the use of acellular dermal matrix and in 2.9% with the use of titanium mesh implant. Nipple-areola necrosis was observed in 1.9% of cases with the use of titanium mesh implant. Infection of implant site was observed in 2.9% of cases. Capsular contracture developed in 5.8% of cases after application of radiotherapy to the reconstructed breast. Conclusions. Biological and synthetic materials form a significant alternative to existing ways of breast reconstruction and, in many cases, adequate replacement of autologous muscular flaps at the proper selection of patients.
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Keywords
рак молочной железы, кожесохранная радикальная мастэктомия с одномоментной реконструкцией имплантатом, подкожная радикальная мастэктомия с одномоментной реконструкцией имплантатом, ацеллюлярный дермальный матрикс, сетчатый имплантат, breast cancer, skin-sparing radical mastectomy with immediate implant reconstruction, subcutaneous radical mastectomy with immediate implant reconstruction, acellular dermal matrix, mesh implantAuthors
| Name | Organization | |
| Ermoshchenkova M.V. | maryerm@mail.ru | |
| Chissov V.I. | ||
| Usov A.V. | ||
| Shirokikh I.M. | ||
| Sukhotko A.S. | ||
| Tukmakov A.Yu. | ||
| Baichorov E.A. | ||
| Zikiryahodjaev A.D. |
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