乳腺癌1期胸肌后假体重建术后短期内发生皮瓣坏死的影响因素

Factors of flap necrosis after breast cancer immediate implant breast reconstruction with submuscular implant reconstruction in the short-term

目的分析乳腺癌患者行1期胸肌后假体重建术后短期内皮瓣坏死的影响因素。方法回顾性分析2018-01—2023-05于郑州大学第一附属医院乳腺外科行乳腺癌1期胸肌后假体重建的264例乳腺癌患者的临床资料,使用t检验和卡方检验分析皮瓣坏死的影响因素,并通过Logistic回归模型进行多因素分析,确定皮瓣坏死的危险因素。结果共有264例乳腺癌患者进行了268台乳房重建手术。经过单因素分析显示,足够的皮瓣厚度和下皱襞切口分别被证明是皮瓣坏死的保护因素(P<0.05)。Logistic回归分析显示,皮瓣厚度和切口类型是皮瓣坏死的独立危险因素(P<0.05)。结论皮瓣厚度和手术切口的选择对乳腺癌1期假体重建后的皮瓣坏死具有显著影响。保留足够的皮瓣厚度,选择下皱襞切口,不仅更加安全,而且更符合美学需求。

Objective To analyze the factors influencing the necrosis of skin flap in breast cancer patients after the first stage of breast muscle prosthesis reconstruction.Methods The clinical data of 264 breast cancer patients who underwent stage 1 reconstruction with posterior pectoralis prosthesis in the Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2023 were retrospectively analyzed.t test and chi-square test were used to analyze the influencing factors of flap necrosis,and Logistic regression model was used for multivariate analysis.The risk factors of flap necrosis were determined.Results A total of 268 breast reconstruction procedures were performed in 264 breast cancer patients.Single factor analysis showed that sufficient flap thickness and inferior plication incision were proved to be protective factors for flap necrosis(P<0.05).Logistic regression analysis showed that flap thickness and inferior fold incision were independent risk factors for flap necrosis(P<0.05).Conclusion The flap thickness and surgical incision have a significant impact on the flap necrosis in breast cancer patients undergoing one-stage reconstruction with prosthesis.For patients undergoing reconstruction,it may be safer and more aesthetic to choose the inferior fold incision with sufficient flap thickness.