頁籤選單縮合
題名 | The Fate of Capsular Contracture in Augmentation Mammaplasty with Silicone Gel Implants=矽膠隆乳後包膜收縮的命運 |
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作者 | 黃培書; 賴永隆; 翁昭仁; | 書刊名 | 中華民國整形外科醫學會雜誌 |
卷期 | 9:4 2000.12[民89.12] |
頁次 | 頁262-268 |
分類號 | 416.414 |
關鍵詞 | 矽膠隆乳; 包膜收縮; Augmentation mammaplasty; Capsular contracture; |
語文 | 英文(English) |
中文摘要 | 使用矽膠填充的義乳來進行隆乳或乳房切除手術後的重建,最常面臨的併發症就是植入周圍形成纖維化包膜的異物反應,包膜的纖維化收嚴重時將導致義乳硬化變形,進而破壞了隆乳手術的美觀效果。我們提出一個罕見的矽膠隆乳病例,因長期的矽膠破裂治漏而導致嚴重的包膜收縮變形及兩則胸大肌、胸小肌與肋間肌液化性壞死及纖維化病變,巨大的纖維化包膜襄腫不僅壓迫週圍的軟組織,也同時侵犯其下方的肋骨、軟骨甚至肋膜,進一步造成了第六、七、八對肋骨及肋軟骨吸收變形與肋膜沾黏。手術方式為直接經由橫切乳房的開放式纖維化包膜完全切除,並小心地將包膜與肋、肋軟骨及肋膜沾黏的部分分離,檢體經病理科診斷為壞死及纖維化組織,無惡性癌細胞;亦無培養出細菌。患者經取出了伴隨14年之久的兩側矽膠包膜囊腫,術後追蹤並無其他身體不適,亦無意願再接受任何的重建手術。 |
英文摘要 | Formation of fibrous capsule around the prosthesis is an inevitable consequence when silicone implants are used for augmentation mammaplasty or post-mastectomy breast reconstruction. Fibrous contracture of the capsule leads to a firm irregular shaped breast, which is unacceptable for both the physicians and the patients. In this paper, we report an unusual case of severe capsular contracture with massive liquefied necrosis of the pectoralis major, minor, and the intercostal muscles secondary to the silicone implants rupture. The large siliconoma invaded not only the adjacent musculature but also the underlying sixth, seventh and eighth ribs, along with the costal cartilage and the parietal pleura. The surgical treatment was open capsulectomy via transverse mammary incisions. Meticulous debridement of the adhered capsule over the ribs, costal cartilage and pleura was performed. The pathology of the debrided material was necrotic tissue and fibrosis with foreign body reaction. The tissue culture was negative for microorganisms. After the removal of the bilateral capsules and siliconomas, the patient did not have any discomfort and denied further reconstruction of the breasts. |
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