ABSTRACT
Objective To explore the safety and cosmetic effect of nipple-sparing modified radical mas tectomy and immediate tissue expander implantation with single circumaereolar incision.Methods 30 patients were enrolled in Peking Union Medical College Hospital between Jan.2014 and Dec.2015.All the patients were categorized according to surgical incision (single circumaereolar incision group vs double incisions group).Data on clinicopathological parameters,average hospital stay,complications and overall cosmetic effect were retrospectively collected.Data was performed with Chi-square test,Fisher exact test and t-test.Statistical significance was defined as P＜0.05.Results 19 patients were enrolled in single circumaereolar incision group,and 11 patients in double incisions group.There was no significant difference for operation duration (P=0.093) and average hospital stay (P=0.339).After follow-up for 19.1 months,ranging from 8 to 31 months,no patients developed seroma or arm lymphedema.There was no statistical significance between the two groups in terms of sensation in nippleaereolar area (P=0.973),bilateral symmetry (P=0.650) and overall cosmesis (P=0.483).Conclusion single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness,reliable oncological safety and decent cosmetic effect.
ABSTRACT
Objective To analyze the risk factors of postoperative infection in patients with skin and soft tissue ex-pander (SSTE)implantation,and provide scientific evidence for making intervention strategies.Methods Question-naires were made,relevant data were obtained through medical record reviewing and telephone inquiry,and case-control method was used to conduct statistical analysis.Results A total of 532 patients were with SSTE implanta-tion,22 (4.14%)of whom had infection,and 14 infected patients were included in this research.Univariate logistic regression analysis indicated that there were significant difference in the number of the embedded expanders (OR=1 .58,95%CI :1 .20-2.32),the implantation site(OR =1 .75,95%CI :1 .30 -2.32),living circumstances of pa-tients(OR=1 .87,95%CI :1 .84 -2.65 ),and whether expanders were regularly disinfected(OR =2.66,95%CI :1 .76-4.32)(all P <0.05).Multivariate logistic regression analysis found that living circumstances of patients(OR=1 .55,95%CI :1 .15-2.25)and whether expanders were regularly disinfected (OR=3.66,95%CI :2.86-3.22) were two main factors entering the regression equation(both P <0.01 ).Conclusion Living circumstances of pa-tients and whether expanders are regularly disinfected are main risk factors of postoperative infection in patients with SSTE embedding.Knowledge education on preventing infection among patients and main caregivers should be strengthened,post-discharge continuous nursing system should be established.