Base de dados : MEDLINE
Pesquisa : E07.695.140 [Categoria DeCS]
Referências encontradas : 4061 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 407 ir para página                         

  1 / 4061 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29384865
[Au] Autor:Qin Q; Tan Q; Lian B; Mo Q; Huang Z; Wei C
[Ad] Endereço:Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
[Ti] Título:Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study.
[So] Source:Medicine (Baltimore);97(5):e9766, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Breast reconstruction after mastectomy plays an active role in improving the quality-of-life (QoL) and alleviating the psychological trauma of breast cancer patients, and has become an indispensable part of the comprehensive treatment in breast cancer. However, compared with mastectomy alone, breast reconstruction also increase operative complications. The surgical, oncological outcomes, and cosmetic effect of breast reconstruction remains to be evaluated. Data for patients with breast cancer who underwent breast reconstruction after mastectomy from February 2009 to November 2015 in our hospital were retrospectively analyzed, with a median follow-up time of 44 months. The operating time, blood loss, drainage fluid, postoperative complications, postoperative cosmesis, oncological outcomes, and QoL were evaluated and compared between different reconstruction types. A total of 151 women were included. The flap-based group had higher complication rates of marginal necrosis of incision, while the incidence of capsular contracture was higher in immediate implant group. There was no difference in blood loss, drainage fluid, and other postoperative complications. Several independent factors were associated with increased postoperative complications included diabetic, obese, and reconstruction with flap. There was no significant difference in the disease-free survival rate and overall survival rate between different surgical groups. In terms of cosmetic effect, patients in the tissue expander group were more likely to get a satisfactory postoperative breast appearance. QoL outcomes shown that the tissue expander group has better body image and sexual enjoyment, while there was no significant difference for other QoL domains. In conclusion, different methods of breast reconstruction are safe and feasible for patients with breast cancer, tissue expander implantation following delayed implant breast reconstruction is a more effective treatment on cosmetic and QoL outcomes.
[Mh] Termos MeSH primário: Neoplasias da Mama/cirurgia
Mamoplastia
Mastectomia
[Mh] Termos MeSH secundário: Adulto
Implantes de Mama
Feminino
Seres Humanos
Meia-Idade
Satisfação do Paciente
Qualidade de Vida
Estudos Retrospectivos
Retalhos Cirúrgicos
Dispositivos para Expansão de Tecidos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009766


  2 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29280857
[Au] Autor:Galdiero M; Larocca F; Iovene MR; Francesca M; Pieretti G; D'Oriano V; Franci G; Ferraro G; d'Andrea F; Nicoletti GF
[Ad] Endereço:Naples, Italy From the Department of Plastic, Reconstructive and Aesthetic Surgery, the Department of Experimental Medicine, Section of Virology and Microbiology, Università della Campania Luigi Vanvitelli; the Unit of Plastic, Reconstructive and Aesthetic Surgery, Università Federico II; and the Department of Public Health.
[Ti] Título:Microbial Evaluation in Capsular Contracture of Breast Implants.
[So] Source:Plast Reconstr Surg;141(1):23-30, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Capsular contracture around breast implants is a severe and unpredictable complication experienced by up to 50 percent of patients after breast augmentation and reconstruction, and represents a major cause leading to reoperation. Several lines of evidence point to the involvement of subclinical infections and of bacterial biofilm formation. METHODS: To reduce the incidence of capsular contracture following mammaplasty, the authors studied the correlation between contamination by exogenous and endogenous bacterial flora and the capacity to develop bacterial biofilm in mammary implants. The authors performed a microbiological study assessing microbial growth of swabs from breast skin, nipple-areola complex, and mammary gland biopsy specimens. Furthermore, the authors compared the results with the data resulting from cultural experiments from biopsy specimens of periprosthetic capsule, contracted or not, and from the surfaces of the relative prosthesis. RESULTS: Between July of 2012 and July of 2013, a series of 65 female patients from the area of Naples, Italy, and its province, who underwent breast plastic surgery with the use of implants for aesthetic or reconstructive reasons, were included in the study. The authors noticed that there is a greater tendency for capsular contracture to form in oncologic patients who received radiotherapy, patients with precedent capsular contracture, and patients with cutaneous contamination by biofilm-producing microbes. CONCLUSIONS: Although all of the new technical procedures tend to reduce the amount of bacterial charge that comes into contact with the prosthesis at the time of its introduction, a minimal amount must always be taken for granted. This is the rationale for a preventative personalized antibiotic therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
[Mh] Termos MeSH primário: Biofilmes
Implante Mamário/instrumentação
Implantes de Mama/microbiologia
Mama/microbiologia
Contratura Capsular em Implantes/microbiologia
Infecções Relacionadas à Prótese/microbiologia
Pele/microbiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Biópsia
Mama/patologia
Mama/cirurgia
Implantes de Mama/efeitos adversos
Candida albicans/isolamento & purificação
Candida albicans/fisiologia
Candidíase/diagnóstico
Candidíase/microbiologia
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Infecções por Klebsiella/diagnóstico
Infecções por Klebsiella/microbiologia
Klebsiella pneumoniae/isolamento & purificação
Klebsiella pneumoniae/fisiologia
Meia-Idade
Infecções Relacionadas à Prótese/diagnóstico
Fatores de Risco
Pele/patologia
Infecções Estafilocócicas/diagnóstico
Infecções Estafilocócicas/microbiologia
Staphylococcus/isolamento & purificação
Staphylococcus/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003915


  3 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29208440
[Au] Autor:Ho AY; Hu ZI; Mehrara BJ; Wilkins EG
[Ad] Endereço:Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: alice.ho@cshs.org.
[Ti] Título:Radiotherapy in the setting of breast reconstruction: types, techniques, and timing.
[So] Source:Lancet Oncol;18(12):e742-e753, 2017 Dec.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:As the use of breast reconstruction and postmastectomy radiotherapy (PMRT) has increased over the past decade, the typical approach to integrating radiotherapy with breast reconstruction has provoked intense controversy in the management of breast cancer. PMRT can lead to an increased frequency of complications in the reconstructed breast. Conversely, the reconstructed breast can increase the complexity of radiotherapy delivery. How to minimise the frequency of complications without compromising oncological or cosmetic outcomes of the reconstructed breast is an important shared multidisciplinary goal for oncologists and their patients. Several questions remain, however, regarding the type of reconstruction that should be used with PMRT, when reconstruction should be done relative to PMRT and whether radiotherapy treatment should be directed towards the tissue expander or the implant for women who opt for a two-stage expander-implant reconstruction. Following advances in the planning of radiotherapy treatment, new questions about the application of these technologies in the setting of breast reconstruction have arisen. In this Review, we address these questions by reviewing contemporary evidence on the optimal integration of radiotherapy and breast reconstruction in the management of breast cancer.
[Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia
Neoplasias da Mama/cirurgia
Mamoplastia/métodos
Radioterapia Adjuvante/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Implante Mamário/efeitos adversos
Implante Mamário/métodos
Implantes de Mama
Feminino
Sobrevivência de Enxerto
Seres Humanos
Mamoplastia/efeitos adversos
Mastectomia/métodos
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/fisiopatologia
Prognóstico
Dose de Radiação
Medição de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


  4 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29176413
[Au] Autor:Hammond DC; Canady JW; Love TR; Wixtrom RN; Caplin DA
[Ad] Endereço:Grand Rapids, Mich.; Irvine, Calif.; Oklahoma City, Okla.; Springfield, Va.; and St. Louis, Mo. From Partners in Plastic Surgery of West Michigan; Mentor Worldwide LLC; private practice; LSCI; and Parkcrest Plastic Surgery.
[Ti] Título:Mentor Contour Profile Gel Implants: Clinical Outcomes at 10 Years.
[So] Source:Plast Reconstr Surg;140(6):1142-1150, 2017 Dec.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Contour Profile Gel/MemoryShape breast implants consist of a textured silicone elastomer shell filled with silicone gel. The objective of this clinical study was to assess the safety and effectiveness of Contour Profile Gel/MemoryShape breast implants in women who were undergoing primary breast augmentation, primary breast reconstruction, or revision surgery (revision-augmentation or revision-reconstruction). METHODS: This was a prospective, open-label, multicenter clinical study involving Contour Profile Gel/MemoryShape breast implants in 955 female subjects, including 572 primary augmentation, 124 revision-augmentation, 190 primary reconstruction, and 69 revision-reconstruction subjects. Safety was assessed based on the incidence, severity, and method of resolution of all complications. Endpoints were examined on both a per-subject and a per-implant basis. RESULTS: For the primary augmentation, revision-augmentation, primary reconstruction, and revision-reconstruction cohorts, the Kaplan-Meier estimated 10-year cumulative incidence rates for the key complications at the subject level were as follows: Baker grade III/IV capsular contracture, 3.6 (primary augmentation), 15.5 (revision-augmentation), 14.3 (primary reconstruction), and 16.4 (revision-reconstruction) percent; infection, 0.7 (primary augmentation), 1.9 (revision-augmentation), 1.6 (primary reconstruction), and 2.9 (revision-reconstruction) percent; explantation with or without replacement, 9.2 (primary augmentation), 25.9 (revision-augmentation), 34.1 (primary reconstruction), and 49.0 (revision-reconstruction) percent; explantation with replacement with study device, 4.0 (primary augmentation), 10.8 (revision-augmentation), 16.7 (primary reconstruction), and 27.9 (revision-reconstruction) percent; and any reoperation, 22.3 (primary augmentation), 35.0 (revision-augmentation), 52.7 (primary reconstruction), and 59.7 (revision-reconstruction) percent. CONCLUSION: The results of this study demonstrate that Contour Profile Gel/MemoryShape breast implants are safe and effective for primary and revision breast augmentation and reconstruction for women at least 22 years old.
[Mh] Termos MeSH primário: Implante Mamário/instrumentação
Implantes de Mama
Mamoplastia/instrumentação
Elastômeros de Silicone
Géis de Silicone
[Mh] Termos MeSH secundário: Adulto
Idoso
Implante Mamário/métodos
Implante Mamário/estatística & dados numéricos
Feminino
Seres Humanos
Mamoplastia/métodos
Mamoplastia/estatística & dados numéricos
Meia-Idade
Segurança do Paciente
Complicações Pós-Operatórias/etiologia
Estudos Prospectivos
Desenho de Prótese
Reoperação
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Silicone Elastomers); 0 (Silicone Gels)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003846


  5 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28457080
[Au] Autor:Levy Y; Ruhrman-Shahar N
[Ad] Endereço:Department of Medicine E, Meir Medical Center, Kfar Saba, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:The Ongoing Debate regarding Long-Term Safety of Silicone Breast Augmentation Rages.
[So] Source:Isr Med Assoc J;18(12):754-755, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Implante Mamário/efeitos adversos
Implantes de Mama/efeitos adversos
Géis de Silicone/efeitos adversos
[Mh] Termos MeSH secundário: Implante Mamário/métodos
Doenças do Tecido Conjuntivo/etiologia
Doenças do Tecido Conjuntivo/patologia
Feminino
Seres Humanos
Desenho de Prótese
Falha de Prótese
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  6 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28457073
[Au] Autor:Klang E; Amitai MM; Raskin S; Rozendorn N; Keddel N; Pickovsky J; Sklair-Levy M
[Ad] Endereço:Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
[Ti] Título:Association between Enlarged Axillary Lymph Nodes and Silicone Breast Implant Ruptures seen on Magnetic Resonance Imaging.
[So] Source:Isr Med Assoc J;18(12):719-724, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Silicone breast augmentation is a common cosmetic surgery. Previous case reports demonstrated lymphadenopathy in the presence of implant ruptures. OBJECTIVES: To investigate the association between enlarged axillary lymph nodes and silicone implant ruptures as seen on breast magnetic resonance imaging (MRI). METHODS: Two groups were derived retrospectively from breast MRI reports in our institution for the period December 2011-May 2014. A search of our hospital records for "silicone" and "lymph node" was performed (group A), and the relationship between the presence of enlarged nodes and ruptures was evaluated. The prevalence of ruptures in the presence of nodes was calculated and the association between MRI imaging features and ruptures evaluated. A search for "silicone" and "implant rupture" was performed (group B) and, as for group A, the relationship between the presence of ruptures and nodes was evaluated and the prevalence of enlarged nodes in the presence of ruptures calculated. RESULTS: Group A comprised 45 women with enlarged nodes. Intracapsular ruptures were associated with nodes (P = 0.005), while extracapsular ruptures showed a trend of association with nodes (P = 0.08). The prevalence of ruptures in the presence of nodes was 31.4%. Nodes associated with ruptures showed a strong silicone signal (P = 0.008) and absent enhancement (P = 0.005). Group B comprised 73 women with ruptures. Enlarged nodes were associated with both intra- and extracapsular ruptures (P < 0.001 and P = 0.002 respectively). The prevalence of nodes in the presence of ruptures was 22.2%. CONCLUSIONS: Enlarged axillary nodes were associated with ruptures in two groups of patients. This finding can guide clinical decisions when either enlarged nodes or ruptures are encountered in patients with silicone implants. The association between silicone lymphadenopathy and implant rupture raises concerns regarding the role of rupture in silicone-induced systemic disease.
[Mh] Termos MeSH primário: Implante Mamário/métodos
Implantes de Mama/efeitos adversos
Linfonodos/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Meia-Idade
Falha de Prótese
Estudos Retrospectivos
Ruptura
Géis de Silicone
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  7 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29068919
[Au] Autor:Danino MA; Nizard N; Paek LS; Govshievich A; Giot JP
[Ad] Endereço:Montreal, Quebec, Canada; and Grenoble, France From the Division of Plastic Surgery, Centre Hospitalier de l'Université de Montréal, Université de Montréal; and the Division of Plastic Surgery, Centre Hospitalier Universitaire Grenoble Alpes.
[Ti] Título:Do Bacteria and Biofilm Play a Role in Double-Capsule Formation around Macrotextured Implants?
[So] Source:Plast Reconstr Surg;140(5):878-883, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The double capsule is a complication mostly described in aggressive macrotextured implants. Mechanical shear stress applied onto an immature periprosthetic capsule has been linked to their formation. The authors aim to demonstrate the role of bacterial phenotype and biofilm in the development of the double capsule. METHODS: Seven double capsules formed at the interface of macrotextured breast expander implants were studied using scanning electron microscopy. Two samples for each surface of the inner capsule layer (the prosthesis interface and the intercapsular space) were analyzed for bacteria cell size, bacterial density, and biofilm deposition. RESULTS: Although all routine bacterial cultures were negative, the prosthesis interface had both higher bacteria load and biofilm deposition compared with the intercapsular space (Mann-Whitney U test, p = 0.004 and p = 0.008, respectively). Moreover, bacteria cell sizes were significantly smaller at the prosthesis interface in six of seven samples. Comparison of bacteria density and biofilm dispersion showed an increase of biofilm extracellular matrix deposition over 2000 cells/mm (linear regression, p = 0.0025). These results indicate a common trend among bacteria species. CONCLUSIONS: Bacterial expression between the different surfaces of the double capsule displays significant differences; bacteria at the prosthesis interface are mostly in a biofilm state, whereas they demonstrate a planktonic phenotype at the intercapsular space. When a sufficient amount of bacteria are present at a specific location, quorum sensing may trigger a biofilm phenotypic switch in planktonic bacteria cells. Biofilm formation may alter capsule formation through immune response, thereby weakening capsule strength and facilitating extracellular matrix delamination and double-capsule formation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
[Mh] Termos MeSH primário: Biofilmes
Implantes de Mama/microbiologia
Reação a Corpo Estranho/microbiologia
Complicações Pós-Operatórias/microbiologia
Dispositivos para Expansão de Tecidos/microbiologia
[Mh] Termos MeSH secundário: Adulto
Implante Mamário/instrumentação
Implante Mamário/métodos
Feminino
Reação a Corpo Estranho/patologia
Seres Humanos
Microscopia Eletrônica de Varredura
Meia-Idade
Complicações Pós-Operatórias/patologia
Estudos Prospectivos
Expansão de Tecido/instrumentação
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003767


  8 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29064922
[Au] Autor:Ter Louw RP; Nahabedian MY
[Ad] Endereço:Falls Church, Va.; and Washington, D.C. From the Inova Fairfax Hospital; MedStar Georgetown University Hospital, and MedStar Washington Hospital Center.
[Ti] Título:Prepectoral Breast Reconstruction.
[So] Source:Plast Reconstr Surg;140(5S Advances in Breast Reconstruction):51S-59S, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Oncologic and reconstructive advancements in the management of patients with breast cancer and at high risk for breast cancer have led to improved outcomes and decreased patient morbidity. Traditional methods for prosthetic breast reconstructions have utilized total or partial muscle coverage of prosthetic devices. Although effective, placement of devices under the pectoralis major muscle can be associated with increased pain due to muscle spasm and animation deformities. Prepectoral prosthetic breast reconstruction has gained popularity in the plastic surgery community, and long-term outcomes have become available. This article will review the indications, technique, and current literature surrounding prepectoral prosthetic breast reconstruction.
[Mh] Termos MeSH primário: Implante Mamário/métodos
Neoplasias da Mama/cirurgia
Mamoplastia/métodos
Músculos Peitorais/cirurgia
[Mh] Termos MeSH secundário: Implantes de Mama
Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003942


  9 / 4061 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28985836
[Au] Autor:Ricci JA; Epstein S; Momoh AO; Lin SJ; Singhal D; Lee BT
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:A meta-analysis of implant-based breast reconstruction and timing of adjuvant radiation therapy.
[So] Source:J Surg Res;218:108-116, 2017 Oct.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Implant-based breast reconstruction is the most common type of reconstruction after postmastectomy radiation therapy (PMRT). The impact of the timing of PMRT to a tissue expander or permanent implant is not well understood. The purpose of this systematic review was to evaluate outcomes in implant-based reconstruction and the timing of PMRT. METHODS: A review of the English literature in the PubMed/MEDLINE database (2000-2016) was performed to identify all articles on implant-based breast reconstruction and PMRT. Cases from each study were grouped by PMRT to a tissue expander or PMRT to a permanent implant. Outcomes of interest included reconstructive failure and capsular contracture as overall rates and associations were pooled. Effect sizes (z values), risk ratios (RRs), and heterogeneity scores (I ) were calculated on meta-analysis. RESULTS: There were 20 studies meeting inclusion criteria with 2348 patients identified. Pooled analysis revealed an overall rate of reconstructive failure of 17.6% and Baker grade III/IV capsular contracture of 37.5%. PMRT applied to tissue expanders resulted in higher rates of reconstructive failure compared with PMRT applied to permanent silicone implants (20% versus 13.4%, RR = 2.33, P = 0.0083, 95% confidence interval 1.24-4.35), but lower rates of capsular contracture (24.5% versus 49.4%, RR = 0.53, P = 0.083, 95% confidence interval 0.26-1.09). CONCLUSIONS: Regardless of timing, PMRT applied to implant-based breast reconstruction was associated with high risk of reconstructive failure and capsular contracture. Surgeons should consider alternative strategies, such as autologous tissue reconstructions, in patients requiring PMRT.
[Mh] Termos MeSH primário: Implante Mamário
Neoplasias da Mama/radioterapia
Mastectomia
[Mh] Termos MeSH secundário: Implante Mamário/instrumentação
Implante Mamário/métodos
Implantes de Mama
Neoplasias da Mama/cirurgia
Feminino
Seres Humanos
Contratura Capsular em Implantes/epidemiologia
Contratura Capsular em Implantes/etiologia
Modelos Estatísticos
Radioterapia Adjuvante
Fatores de Tempo
Expansão de Tecido/instrumentação
Dispositivos para Expansão de Tecidos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


  10 / 4061 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28953716
[Au] Autor:Singh N; Picha GJ; Hardas B; Schumacher A; Murphy DK
[Ad] Endereço:Chevy Chase, Md.; Brecksville, Ohio; and Irvine, Calif. From Washingtonian Plastic Surgery; Applied Medical Technology, Inc.; and Allergan plc.
[Ti] Título:Five-Year Safety Data for More than 55,000 Subjects following Breast Implantation: Comparison of Rare Adverse Event Rates with Silicone Implants versus National Norms and Saline Implants.
[So] Source:Plast Reconstr Surg;140(4):666-679, 2017 Oct.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The U.S. Food and Drug Administration has required postapproval studies of silicone breast implants to evaluate the incidence of rare adverse events over 10 years after implantation. METHODS: The Breast Implant Follow-Up Study is a large 10-year study (>1000 U.S. sites) evaluating long-term safety following primary augmentation, revision-augmentation, primary reconstruction, or revision-reconstruction with Natrelle round silicone breast implants compared with national norms and outcomes with saline implants. Targeted adverse events in subjects followed for 5 to 8 years included connective tissue diseases, neurologic diseases, cancer, and suicide. RESULTS: The safety population comprised 55,279 women (primary augmentation, n = 42,873; revision-augmentation, n = 6837; primary reconstruction, n = 4828; and revision-reconstruction, n = 741). No targeted adverse events occurred at significantly greater rates in silicone implant groups versus national norms across all indications. The standardized incidence rate (observed/national norm) for all indications combined was 1.4 for cervical/vulvar cancer, 0.8 for brain cancer, 0.3 for multiple sclerosis, and 0.1 for lupus/lupus-like syndrome. Silicone implants did not significantly increase the risk for any targeted adverse events compared with saline implants. The risk of death was similar with silicone versus saline implants across all indications. The suicide rate (10.6 events per 100,000 person-years) was not significantly higher than the national norm. No implant-related deaths occurred. CONCLUSIONS: Results from 5 to 8 years of follow-up for a large number of subjects confirmed the safety of Natrelle round silicone implants, with no increased risk of systemic disease or suicide versus national norms or saline implants. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
[Mh] Termos MeSH primário: Implantes de Mama/efeitos adversos
Previsões
Contratura Capsular em Implantes/epidemiologia
Géis de Silicone/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Incidência
Meia-Idade
Satisfação do Paciente
Desenho de Prótese
Falha de Prótese
Reoperação
Estudos Retrospectivos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003711



página 1 de 407 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde