View : 526 Download: 143
Pure hemi-periareolar incision versus conventional lateral radial incision mastectomy and direct-to-implant breast reconstructions: comparison of indocyanine green angiographic perfusion and necrosis of the nipple
- Title
- Pure hemi-periareolar incision versus conventional lateral radial incision mastectomy and direct-to-implant breast reconstructions: comparison of indocyanine green angiographic perfusion and necrosis of the nipple
- Authors
- Park, Jin-Woo; Seong, Ik Hyun; Lim, Woosung; Woo, Kyong-Je
- Ewha Authors
- 임우성; 우경제; 박진우
- SCOPUS Author ID
- 임우성; 우경제; 박진우
- Issue Date
- 2020
- Journal Title
- GLAND SURGERY
- ISSN
- 2227-684X
2227-8575
- Citation
- GLAND SURGERY vol. 9, no. 5, pp. 1193 - 1204
- Keywords
- Direct-to-implant breast reconstruction; nipple-sparing mastectomy; indocyanine green; nipple-areola complex necrosis; mastectomy skin flap
- Publisher
- AME PUBL CO
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: This study evaluated the feasibility of direct-to-implant breast reconstruction after nipple-sparing mastectomy using pure hemi-periareolar incision without extension and with the aid of indocyanine green angiographic evaluation on the mastectomy skin flap. Methods: Patients who underwent immediate direct-to-implant breast reconstruction from December 2018 to February 2020 were included. After nipple-sparing mastectomy, indocyanine green angiographic evaluation of perfusion to nipple-areola complex was performed by video recording with a near infrared camera, and nipple perfusion time and perfusion pattern were analyzed. Patients were divided into a pure hemi-periareolar incision group and conventional lateral radial incision groups to compare nipple perfusion and surgical outcomes. Results: A total of 61 breasts in 56 patients were included. Pure hemi-periareolar incision was used in 41 breasts, and conventional lateral radial incisions were used in 20 breasts. Nipple perfusion time was significantly increased in the pure hemi-periareolar incision group (79.6 +/- 65.8 vs. 43.2 +/- 49.8 seconds, P=0.031). While minor nipple-areola complex necrosis was significantly increased in the pure hemiperiareolar incision group (19.5% versus 0%; P=0.044), major nipple-areola complex necrosis (2.4% versus 5.0%; P>0.999) was not significantly different between the two groups. The rates of nipple-areola complex necrosis were 0%, 16.7%, and 63.6% in rapid, delayed, and no perfusion groups, respectively (P<0.001). No nipple perfusion pattern was a significant predictor for nipple-areola complex necrosis in univariable and multivariable analyses (P<0.001). There was no case of reconstruction failure. Conclusions: Immediate direct-to-implant breast reconstruction after nipple-sparing mastectomy using pure hemi-periareolar incision can be safely performed using indocyanine green angiographic evaluation on the mastectomy skin flap.
- DOI
- 10.21037/gs-20-506
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
-
52878-PB15-9532-R3.pdf(1.83 MB)
Download
- Export
- RIS (EndNote)
- XLS (Excel)
- XML