Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes
Background. Simultaneous breast reconstruction after subcutaneous or skin-sparing mastectomy using silicone implants is associated with a high risk of postoperative complications. Therefore, the issue of additional shell cover for breast implants is highly relevant. Synthetic and biological implants...
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ABV-press
2024-01-01
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| Series: | Опухоли женской репродуктивной системы |
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| Online Access: | https://ojrs.abvpress.ru/ojrs/article/view/1163 |
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| author | D. Sh. Dzhabrailova A. D. Zikiryakhodzhaev F. N. Usov D. V. Bagdasarova I. S. Duadze A. D. Kaprin |
| author_facet | D. Sh. Dzhabrailova A. D. Zikiryakhodzhaev F. N. Usov D. V. Bagdasarova I. S. Duadze A. D. Kaprin |
| author_sort | D. Sh. Dzhabrailova |
| collection | DOAJ |
| description | Background. Simultaneous breast reconstruction after subcutaneous or skin-sparing mastectomy using silicone implants is associated with a high risk of postoperative complications. Therefore, the issue of additional shell cover for breast implants is highly relevant. Synthetic and biological implants are believed to be the most effective.Aim. To assess the efficacy and safety of autologous dura mater grafts in reconstructive surgeries for breast cancer patients.Materials and methods. This study included 164 patients who had undergone subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using implants and additional shell cover with either autologous dura mater grafts (experimental group, n = 83) or synthetic mesh implants (control group, n = 81) between 2017 and 2022. The mean patients’ age was 41.4 ± 7.2 years (41.2 ± 7.1 years in the experimental group and 41.6 ± 7.2 years in the control group). The mean follow-up time was 38.0 ± 21.4 months (min: 12 months; max: 80 months).Results. The 3-year relapse-free survival rate was 100 %. The 3-year progression-free survival was 97.4 % (95 % confidence interval 92.6–100.0 %). We observed no significant differences in the time to disease progression between the experimental and control group (p = 0.573). The assessment of aesthetic outcomes using a special surgical questionnaire showed excellent cosmetic and psycho-emotional results. Patients in both groups demonstrated comparable cosmetic results (p >0.05); however, psychoemotional satisfaction with surgery results was higher in the experimental group (p<0.05). Postoperative complications (primarily capsule contracture) were registered in 18 patients from the experimental group (21.7 %) and 31 patients from the control group (38.3 %) (p0.05). We also calculated the incidence rate ratio (IRR) and found that the difference was due to different follow-up time. Clinically significant capsule contracture was observed in 9 patients from the experimental group (10.8 %). The incidence of capsule contracture was higher among patients who had radiation therapy than in those who had no radiation therapy (15.8 % and 0.0 %, respectively; p<0.05).Conclusion. Subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using silicone implants and autologous dura mater grafts is a safe and effective surgical method for breast cancer patients. The analysis of the international Breast-Q questionnaire results and surgical questionnaire results demonstrated that all patients had a high quality of life after simultaneous breast reconstruction using an autologous dura mater graft. |
| format | Article |
| id | doaj-art-b590cbd6f730464ab2c54cbc69725b90 |
| institution | Kabale University |
| issn | 1994-4098 1999-8627 |
| language | Russian |
| publishDate | 2024-01-01 |
| publisher | ABV-press |
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| series | Опухоли женской репродуктивной системы |
| spelling | doaj-art-b590cbd6f730464ab2c54cbc69725b902025-08-20T03:38:23ZrusABV-pressОпухоли женской репродуктивной системы1994-40981999-86272024-01-01194435310.17650/1994-4098-2023-19-4-43-53820Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomesD. Sh. Dzhabrailova0A. D. Zikiryakhodzhaev1F. N. Usov2D. V. Bagdasarova3I. S. Duadze4A. D. Kaprin5P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of RussiaP. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; Peoples’ Friendship University of RussiaP. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of RussiaP. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of RussiaP. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaP. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia; Peoples’ Friendship University of RussiaBackground. Simultaneous breast reconstruction after subcutaneous or skin-sparing mastectomy using silicone implants is associated with a high risk of postoperative complications. Therefore, the issue of additional shell cover for breast implants is highly relevant. Synthetic and biological implants are believed to be the most effective.Aim. To assess the efficacy and safety of autologous dura mater grafts in reconstructive surgeries for breast cancer patients.Materials and methods. This study included 164 patients who had undergone subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using implants and additional shell cover with either autologous dura mater grafts (experimental group, n = 83) or synthetic mesh implants (control group, n = 81) between 2017 and 2022. The mean patients’ age was 41.4 ± 7.2 years (41.2 ± 7.1 years in the experimental group and 41.6 ± 7.2 years in the control group). The mean follow-up time was 38.0 ± 21.4 months (min: 12 months; max: 80 months).Results. The 3-year relapse-free survival rate was 100 %. The 3-year progression-free survival was 97.4 % (95 % confidence interval 92.6–100.0 %). We observed no significant differences in the time to disease progression between the experimental and control group (p = 0.573). The assessment of aesthetic outcomes using a special surgical questionnaire showed excellent cosmetic and psycho-emotional results. Patients in both groups demonstrated comparable cosmetic results (p >0.05); however, psychoemotional satisfaction with surgery results was higher in the experimental group (p<0.05). Postoperative complications (primarily capsule contracture) were registered in 18 patients from the experimental group (21.7 %) and 31 patients from the control group (38.3 %) (p0.05). We also calculated the incidence rate ratio (IRR) and found that the difference was due to different follow-up time. Clinically significant capsule contracture was observed in 9 patients from the experimental group (10.8 %). The incidence of capsule contracture was higher among patients who had radiation therapy than in those who had no radiation therapy (15.8 % and 0.0 %, respectively; p<0.05).Conclusion. Subcutaneous or skin-sparing mastectomy with simultaneous breast reconstruction using silicone implants and autologous dura mater grafts is a safe and effective surgical method for breast cancer patients. The analysis of the international Breast-Q questionnaire results and surgical questionnaire results demonstrated that all patients had a high quality of life after simultaneous breast reconstruction using an autologous dura mater graft.https://ojrs.abvpress.ru/ojrs/article/view/1163breast cancerbreast reconstructionautologous dura mater graftlyophilized dura materacellular dermal matrixmesh implantmastectomy |
| spellingShingle | D. Sh. Dzhabrailova A. D. Zikiryakhodzhaev F. N. Usov D. V. Bagdasarova I. S. Duadze A. D. Kaprin Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes Опухоли женской репродуктивной системы breast cancer breast reconstruction autologous dura mater graft lyophilized dura mater acellular dermal matrix mesh implant mastectomy |
| title | Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes |
| title_full | Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes |
| title_fullStr | Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes |
| title_full_unstemmed | Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes |
| title_short | Autologous dura mater grafts in reconstructive surgeries for breast cancer: surgical and aesthetic outcomes |
| title_sort | autologous dura mater grafts in reconstructive surgeries for breast cancer surgical and aesthetic outcomes |
| topic | breast cancer breast reconstruction autologous dura mater graft lyophilized dura mater acellular dermal matrix mesh implant mastectomy |
| url | https://ojrs.abvpress.ru/ojrs/article/view/1163 |
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