Controversia en la reconstrucción mamaria con implante: uso de plano prepectoral vrs plano subpectoral
Loading...
Date
Authors
Maria Laura Meza Salas
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
El cáncer de mama es una de las enfermedades oncológicas más prevalentes en mujeres en el ámbito mundial, con un incremento en la incidencia del 0.6 % desde mediados de los años 2000. Los tratamientos han evolucionado significativamente y se ofrece a las pacientes en cualquier estadio una sobrevida más prometedora. La cirugía, que forma parte integral del tratamiento, ha progresado de procedimientos radicales a técnicas más conservadoras de tejido.
La resección del tejido mamario, sin embargo, afecta la apariencia y el ámbito emocional de las mujeres, causa alteraciones psicológicas y dificultades en la integración social. La reconstrucción mamaria ofrecediversastécnicaspararestaurarlafaltadetejidotrasunamastectomía,estoincluye el uso de tejido autólogo y la introducción de implantes de silicona, que es actualmente el procedimiento más común.
La evolución en la tecnología ha permitido avanzar en la seguridad de los tratamientos reconstructivos. Métodos objetivos e inmediatos, como el uso de verde indocianina, facilitan la toma de decisiones intraoperatorias y reducen el riesgo de complicaciones posoperatorias. Asimismo, la matriz dérmica acelular ha demostrado ser un aliado crucial en las cirugías reconstructivas.
La controversia sobre el mejor plano de reconstrucción con implante persiste. El plano submuscular ha sido el favorito de la mayoría de los cirujanos por muchos años. Recientemente, las nuevas tecnologías y matrices dérmicas han reintroducido el plano prepectoral como una opción viable. Es esencial analizar los factores a favor y en contra de cada técnica quirúrgica para ofrecer la mejor cirugía con el menor riesgo de complicaciones.
viii
Debido a que el 80 % de las pacientes elige la reconstrucción con implantes, es fundamental entender los posibles riesgos y complicaciones asociados con cada técnica y comprender la diferencia en la incidencia de hematomas, seromas, infecciones, necrosis, dolor, contractura capsular, deformidad por animación, calidad de vida y supervivencia de cada una.
Breast cancer is one of the most prevalent oncological diseases among women worldwide, with an incidence increase of 0.6 % since the mid-2000s. Treatments have evolved significantly, offering patients at any stage more promising survival rates. Surgery, an integral part of treatment, has progressed from radical procedures to more tissue-preservation techniques. However, the resection of breast tissue affects women's physical appearance and emotional well- being, causing psychological effects and social integration difficulties. Breast reconstruction offers various techniques to restore the lack of tissue after a mastectomy, including the use of autologous tissue and the use of silicone implants, which is currently the most common procedure. Technological advancements have improved the safety of reconstructive treatments. Among this advancements, objective and immediate methods, such as the use of indocyanine green, facilitate intraoperative decision-making and reduce the risk of postoperative complications. Additionally, acellular dermal matrices have proven to be crucial allies in reconstructive surgeries. The controversy over the best plane for implant-based reconstruction persists. The submuscular plane has been the preferred choice for most surgeons for many years. Recently, new technologies and dermal matrices have reintroduced the prepectoral plane as a viable option. It is essential to analyze the pros and cons of each surgical technique to offer the best surgery with the least risk of complications. Since 80 % of patients choose implant-based reconstruction, it is crucial to understand the possible risks and complications associated with each technique, including the incidence of hematomas, seromas, infections, necrosis, pain, capsular contracture, animation deformity, quality of life, and survival.
Breast cancer is one of the most prevalent oncological diseases among women worldwide, with an incidence increase of 0.6 % since the mid-2000s. Treatments have evolved significantly, offering patients at any stage more promising survival rates. Surgery, an integral part of treatment, has progressed from radical procedures to more tissue-preservation techniques. However, the resection of breast tissue affects women's physical appearance and emotional well- being, causing psychological effects and social integration difficulties. Breast reconstruction offers various techniques to restore the lack of tissue after a mastectomy, including the use of autologous tissue and the use of silicone implants, which is currently the most common procedure. Technological advancements have improved the safety of reconstructive treatments. Among this advancements, objective and immediate methods, such as the use of indocyanine green, facilitate intraoperative decision-making and reduce the risk of postoperative complications. Additionally, acellular dermal matrices have proven to be crucial allies in reconstructive surgeries. The controversy over the best plane for implant-based reconstruction persists. The submuscular plane has been the preferred choice for most surgeons for many years. Recently, new technologies and dermal matrices have reintroduced the prepectoral plane as a viable option. It is essential to analyze the pros and cons of each surgical technique to offer the best surgery with the least risk of complications. Since 80 % of patients choose implant-based reconstruction, it is crucial to understand the possible risks and complications associated with each technique, including the incidence of hematomas, seromas, infections, necrosis, pain, capsular contracture, animation deformity, quality of life, and survival.
Description
Keywords
Cirugía plástica, reconstrucción mamaria, implantes