Отсроченные эстетические результаты реконструкции молочной железы и влияние осложнений на итоговый эстетический результат: сравнительный анализ в проспективно-ретроспективном когортном исследовании
Автор: Хомиди У.Х., Сарибекян Э.К., Запиров Г.М., Кодзоева Д.Б., Аблицова Н.В., Хугаева Ф.С., Дуадзе И.С., Джабраилова Д.Ш., Зикиряходжаев А.Д., Каприн А.Д.
Журнал: Вестник Российского научного центра рентгенорадиологии Минздрава России @vestnik-rncrr
Рубрика: Маммология
Статья в выпуске: 1 т.26, 2026 года.
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Цель: оценить отсроченные эстетические результаты реконструктивных операций с эндопротезированием, выполненных по поводу рака молочной железы в зависимости от хирургической тактики и определить влияние клинико-терапевтических факторов риска в рамках проспективно- ретроспективного когортного исследования.
Рак молочной железы, реконструкция молочной железы, имплантационная реконструкция, одномоментная реконструкция, двухэтапная реконструкция, тканевой экспандер, капсулярная контрактура, лучевая терапия, эстетические результаты, качество жизни
Короткий адрес: https://sciup.org/149151025
IDR: 149151025 | УДК: 618.19-006-089.844 | DOI: 10.24412/1999-7264-2026-1-41-54
Delayed aesthetic outcomes of breast reconstruction and the impact of complications on the final aesthetic outcome: A comparative analysis in a prospective-retrospective cohort study
Objective: To evaluate the long-term aesthetic outcomes of breast reconstruction using implants in breastcancer patients, according to surgical strategies, and to determine the impact of key clinical risk factors in a prospective- retrospective cohort study.Materials and methods. The study included 160 patients who were treated at the P.A. Hertsen Moscow Oncology Research Institute between 2013 and 2020. Three groups were analyzed: immediate reconstruction without additional implant coverage (n=40), immediate reconstruction with additional implant cover (acellular dermal matrix, mesh, or latissimus dorsi flaps; n=50) and two-stage expansion-implantation reconstruction (n =70). Risk factors included radiation therapy, smoking, obesity, age and comorbidity. Aesthetic outcomes were evaluated using the standardized Russian ROOM questionnaire ("Assessment of cosmetic results and psychological criteria after breast conservation surgery, oncoplasty resections, and reconstructive plastic procedures in breast cancer patients") and independent expert assessment. Median follow-up period was 7.9 years. Statistical analysis included chi-square test, Fisher exact test, Spearman's correlation coefficient, odds ratio with 95% confidence interval, and significance level set at pResults. The best long-term aesthetic outcomes were achieved in the immediate reconstruction group with additional implant coverage. Radiotherapy was associated with an increased risk of severe capsular contracture (OR=3.4). Smoking and obesity showed a trend towards higher rates of early and late complications, respectively (OR = 2.4; 95% CI: 1.0 - 5.6, and OR = 2,2; 95 % CI: 0.9 - 4.8) Conclusion. Reconstructive strategy should be individualized based on oncologic status, soft tissue characteristics, and risk profile. Additional implant coverage provides a more stable long term aesthetic outcome.
