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Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix

Background: The aim of this study was to compare outcomes of immediate prosthetic breast reconstruction (IPBR) using traditional submuscular (SM) positioning of implants versus prepectoral (PP) positioning of micropolyurethane-foam-coated implants (microthane) without further coverage. Methods: We r...

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Autores principales: Franceschini, Gianluca, Scardina, Lorenzo, Di Leone, Alba, Terribile, Daniela Andreina, Sanchez, Alejandro Martin, Magno, Stefano, D’Archi, Sabatino, Franco, Antonio, Mason, Elena Jane, Carnassale, Beatrice, Murando, Federica, Orlandi, Armando, Barone Adesi, Liliana, Visconti, Giuseppe, Salgarello, Marzia, Masetti, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926428/
https://www.ncbi.nlm.nih.gov/pubmed/33671712
http://dx.doi.org/10.3390/jpm11020153
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author Franceschini, Gianluca
Scardina, Lorenzo
Di Leone, Alba
Terribile, Daniela Andreina
Sanchez, Alejandro Martin
Magno, Stefano
D’Archi, Sabatino
Franco, Antonio
Mason, Elena Jane
Carnassale, Beatrice
Murando, Federica
Orlandi, Armando
Barone Adesi, Liliana
Visconti, Giuseppe
Salgarello, Marzia
Masetti, Riccardo
author_facet Franceschini, Gianluca
Scardina, Lorenzo
Di Leone, Alba
Terribile, Daniela Andreina
Sanchez, Alejandro Martin
Magno, Stefano
D’Archi, Sabatino
Franco, Antonio
Mason, Elena Jane
Carnassale, Beatrice
Murando, Federica
Orlandi, Armando
Barone Adesi, Liliana
Visconti, Giuseppe
Salgarello, Marzia
Masetti, Riccardo
author_sort Franceschini, Gianluca
collection PubMed
description Background: The aim of this study was to compare outcomes of immediate prosthetic breast reconstruction (IPBR) using traditional submuscular (SM) positioning of implants versus prepectoral (PP) positioning of micropolyurethane-foam-coated implants (microthane) without further coverage. Methods: We retrospectively reviewed the medical records of breast cancer patients treated by nipple-sparing mastectomy (NSM) and IPBR in our institution during the two-year period from January 2018 to December 2019. Patients were divided into two groups based on the plane of implant placement: SM versus PP. Results: 177 patients who received IPBR after NSM were included in the study; implants were positioned in a SM plane in 95 patients and in a PP plane in 82 patients. The two cohorts were similar for mean age (44 years and 47 years in the SM and PP groups, respectively) and follow-up (20 months and 16 months, respectively). The mean operative time was 70 min shorter in the PP group. No significant differences were observed in length of hospital stay or overall major complication rates. Statistically significant advantages were observed in the PP group in terms of aesthetic results, chronic pain, shoulder dysfunction, and skin sensibility (p < 0.05), as well as a trend of better outcomes for sports activity and sexual/relationship life. Cost analysis revealed that PP-IPBR was also economically advantageous over SM-IPBR. Conclusions: Our preliminary experience seems to confirm that PP positioning of a polyurethane-coated implant is a safe, reliable and effective method to perform IPBR after NSM.
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spelling pubmed-79264282021-03-04 Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix Franceschini, Gianluca Scardina, Lorenzo Di Leone, Alba Terribile, Daniela Andreina Sanchez, Alejandro Martin Magno, Stefano D’Archi, Sabatino Franco, Antonio Mason, Elena Jane Carnassale, Beatrice Murando, Federica Orlandi, Armando Barone Adesi, Liliana Visconti, Giuseppe Salgarello, Marzia Masetti, Riccardo J Pers Med Article Background: The aim of this study was to compare outcomes of immediate prosthetic breast reconstruction (IPBR) using traditional submuscular (SM) positioning of implants versus prepectoral (PP) positioning of micropolyurethane-foam-coated implants (microthane) without further coverage. Methods: We retrospectively reviewed the medical records of breast cancer patients treated by nipple-sparing mastectomy (NSM) and IPBR in our institution during the two-year period from January 2018 to December 2019. Patients were divided into two groups based on the plane of implant placement: SM versus PP. Results: 177 patients who received IPBR after NSM were included in the study; implants were positioned in a SM plane in 95 patients and in a PP plane in 82 patients. The two cohorts were similar for mean age (44 years and 47 years in the SM and PP groups, respectively) and follow-up (20 months and 16 months, respectively). The mean operative time was 70 min shorter in the PP group. No significant differences were observed in length of hospital stay or overall major complication rates. Statistically significant advantages were observed in the PP group in terms of aesthetic results, chronic pain, shoulder dysfunction, and skin sensibility (p < 0.05), as well as a trend of better outcomes for sports activity and sexual/relationship life. Cost analysis revealed that PP-IPBR was also economically advantageous over SM-IPBR. Conclusions: Our preliminary experience seems to confirm that PP positioning of a polyurethane-coated implant is a safe, reliable and effective method to perform IPBR after NSM. MDPI 2021-02-22 /pmc/articles/PMC7926428/ /pubmed/33671712 http://dx.doi.org/10.3390/jpm11020153 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Franceschini, Gianluca
Scardina, Lorenzo
Di Leone, Alba
Terribile, Daniela Andreina
Sanchez, Alejandro Martin
Magno, Stefano
D’Archi, Sabatino
Franco, Antonio
Mason, Elena Jane
Carnassale, Beatrice
Murando, Federica
Orlandi, Armando
Barone Adesi, Liliana
Visconti, Giuseppe
Salgarello, Marzia
Masetti, Riccardo
Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title_full Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title_fullStr Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title_full_unstemmed Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title_short Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix
title_sort immediate prosthetic breast reconstruction after nipple-sparing mastectomy: traditional subpectoral technique versus direct-to-implant prepectoral reconstruction without acellular dermal matrix
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926428/
https://www.ncbi.nlm.nih.gov/pubmed/33671712
http://dx.doi.org/10.3390/jpm11020153
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