BİLATERAL MEME REKONSTRÜKSİYONU

Yıl 2008, Cilt: 16 Sayı: 3, 134 - 139, 01.12.2008

Burçak TÜMERDEM Uluğ İsmail Kuran

Öz

Sürekli takip gerektiren premalign lezyonların varlığında, aile anamnezinde ve genetik testlerle meme kanseri riski yüksek bulunanlarda, erken dönem meme kanseri saptananlarda deri koruyucu mastektomi gündeme gelmekte olup bilateral meme rekonstrüksiyonu endikasyonu gittikçe artmaktadır. Bu çalışmamızda 17 hasta değerlendirmeye alındı. Bilateral meme rekonstrüksiyonlarının kendine özgü zorluklarının aşılabilmesi için ameliyat öncesi planlamanın önemi, protez ile rekonstrüksiyonda pektoralis kas diseksiyonunun detayları ve protez seçiminde Cohesive III protezlerinin değeri sorgulandı. İki hastada tek tarafa transvers rektus abdominis kas-deri flebi ve diğer tarafa meme protezi, iki hastada tek tarafa latissimus dorsi (LD) kas-deri flebiyle birlikte protez ve diğer tarafa sadece protez, bir hastada iki tarafa LD kas-deri flebiyle birlikte protez uygulandı. Geri kalan tüm hastalarda iki taraflı meme protezi ile rekonstrüksiyon gerçekleştirildi. 17 hastanın %85'inde sonuçlar iyi olarak değerlendirildi. % 20 oranında minör revizyonlar gerekti. Bilateral meme rekonstrüksiyonu teknik zorluklar ve her iki memede simetri sağlanmasındaki güçlükler gibi dezavantajlarının yanısıra rekonstrükte meme ile simetri gerektirecek pitotik meme yokluğu gibi avantajları içerir. Yumuşak doku zarfının yeterli olduğu durumlarda hasta otojen doku ile rekonstrüksiyonu kabul etmiyorsa, daha kısa operasyon ve daha hızlı iyileşme süresi sağlayan protez ile rekonstrüksiyon ideal bir seçenektir.

Anahtar Kelimeler

Bilateral mastektomi, meme rekonstrüksiyonu, protez

BILATERAL BREAST RECONSTRUCTION

Öz

The increasing incidence of bilateral mastectomy for breast cancer and premalignant breast disease, with a significant improvement in methods available for mastectomy reconstruction has led to an increase in the indication for bilateral breast reconstruction. Seventeen patients who underwent bilateral breast reconstruction are evaluated in this study. The importance of preoperative planning to overcome the difficulties of bilateral breast reconstruction, the operation details of reconstruction with implant and the advantages of cohesive III implant are discussed. Two patients underwent reconstruction of one breast with transverse rectus abdominis myocutaneous flap and the other breast with implant. Two patients underwent reconstruction of one breast with latissimus dorsi myocutaneous flap and implant, the other breast only with implant. One patient had bilateral latissimus dorsi myocutaneous flap with implant reconstruction. Implants were used for bilateral breast reconstruction in the remaining. The results were evaluated in 85% as “good” and minor revisions were needed in 20%. Simultaneous bilateral breast reconstruction presents unique challenges and technically, it is much more difficult than a unilateral reconstruction. However, one of its advantages is that there is not any ptotic contralateral breast which frequently causes difficulty to obtain symmetry with. If the patient does not accept breast reconstruction with autogenous tissue and had sufficient soft tissue coverage, bilateral breast reconstruction with implant is an ideal option with its shorter operation and healing time. Keywords: Bilateral mastectomy, breast

Anahtar Kelimeler

Bilateral mastectomy, breast reconstruction, implant

Kaynakça

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