surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2025-15-4-354-363surgonco-1148Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESОдномоментная реконструкция молочной железы с использованием гладких круглых имплантатов: отдаленные результатыImmediate Breast Reconstruction Using Smooth Round Implants: Long-Term Resultshttps://orcid.org/0000-0002-3681-4685ПахомоваР. А.PakhomovaR. A.

Пахомова Регина Александровна — д.м.н., доцент, кафедра пластической хирургии

Москва 

Regina A. Pakhomova — Dr. Sci. (Med.), Assoc. Prof., Department of Plastic Surgery

Moscow 

https://orcid.org/0000-0003-0827-7998СарибекянЭ. К.SaribekyanE. K.

Сарибекян Эрик Карлович — д.м.н., доцент, кафедра пластической хирургии

Москва 

Erik K. Saribekyan — Dr. Sci. (Med.), Assoc. Prof., Department of Plastic Surgery

Moscow 

https://orcid.org/0000-0001-5784-7067КочетоваЛ. В.KochetovaL. V.

Кочетова Людмила Викторовна — к.м.н., профессор, кафедра общей хирургии

Красноярск 

Lyudmila V. Kochetova — Cand. Sci. (Med.), Prof., Department of General Surgery

Krasnoyarsk 

https://orcid.org/0000-0001-6732-6564АбдугаффоровС. А.AbdugafforovS. A.

Абдугаффоров Сардор Абдугаффорович — аспирант, кафедра пластической хирургии

Москва

Sardor A. Abdugafforov — Postgraduate Student, Department of Plastic Surgery

Moscow 

https://orcid.org/0009-0001-6572-2392КолесникВ. Я.KolesnikV. Ya.

Колесник Василий Ярославович — аспирант, кафедра пластической хирургии

Москва

Vasiliy Ya. Kolesnik — Postgraduate Student, Department of Plastic Surgery

Moscow 

v.kolesnik@bk.ruhttps://orcid.org/0000-0002-7223-0150ВоротниковВ. В.VorotnikovV. V.

Воротников Владимир Владимирович — к.м.н. доцент, кафедра пластической хирургии

Москва

Vladimir V. Vorotnikov — Cand. Sci. (Med.), Assoc. Prof., Department of Plastic Surgery

Moscow 

https://orcid.org/0000-0003-2713-0115КопытичИ. В.KopytichI. V.

Копытич Игорь Викторович — аспирант, кафедра пластической хирургии

Москва

Igor V. Kopytich — Postgraduate Student, Department of Plastic Surgery

Moscow 

Российский биотехнологический университет (РОСБИОТЕХ)РоссияRussian Biotechnological University (ROSBIOTECH)Russian FederationКрасноярский государственный медицинский университет им. профессора В.Ф. Войно-ЯсенецкогоРоссияVoino-Yasenetsky Krasnoyarsk State Medical UniversityRussian Federation202524122025154354363Copyright © Пахомова Р.А., Сарибекян Э.К., Кочетова Л.В., Абдугаффоров С.А., Колесник В.Я., Воротников В.В., Копытич И.В., 20252025Пахомова Р.А., Сарибекян Э.К., Кочетова Л.В., Абдугаффоров С.А., Колесник В.Я., Воротников В.В., Копытич И.В.Pakhomova R.A., Saribekyan E.K., Kochetova L.V., Abdugafforov S.A., Kolesnik V.Y., Vorotnikov V.V., Kopytich I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1148

Введение. Одномоментная реконструкция молочной железы с использованием гладких круглых имплантатов вновь приобрела актуальность после отказа от текстурированных моделей из-за ассоциации с BIA-ALCL. Однако отдаленные результаты DTI-реконструкции с гладкими имплантами остаются слабоизученными. Настоящее исследование направлено на оценку безопасности и эффективности этого метода. Материалы и методы. В ретроспективное исследование включены 48 пациенток (64 молочные железы), перенесших подкожную мастэктомию с одномоментной реконструкцией гладкими имплантатами (без использования дополнительных укрывающих материалов). Период наблюдения составил в среднем 54,5 месяца. Проанализированы частота осложнений, онкологические и хирургические данные, а также факторы риска удаления или замены имплантатов. Результаты. Ранние осложнения составили 10,94 % (наиболее частое — частичный некроз ареолы), поздние — 20,31 % (преимущественно капсулярная контрактура III–IV ст. по Бейкеру). В 75 % случаев имплантат был сохранен. Высокий ИМТ, большой объем имплантата и вес удаленной ткани были значимыми факторами в развитии осложнений. Обсуждение. Полученные данные демонстрируют сопоставимые или лучшие показатели по сравнению с зарубежными исследованиями. Отсутствие укрывающих материалов и субпекторальная установка не увеличивали частоту инфекций, но коррелировали с анимационной деформацией. Наличие послеоперационной лучевой терапии существенно повышало риск контрактуры. Заключение. Одномоментная реконструкция молочной железы с применением гладких имплантатов демонстрирует удовлетворительные отдаленные результаты при низком уровне осложнений. Метод может рассматриваться как безопасная альтернатива в условиях ограниченного доступа к ADM.

Introduction. Immediate breast reconstruction using smooth round implants has regained popularity following the abandonment of textured models due to their association with BIA-ALCL. However, the long-term results of DTI reconstruction with smooth implants remain poorly studied. The present study aims to evaluate the safety and efficiency of this method. Materials and methods. The retrospective study includes 48 patients (64 breasts) who underwent subcutaneous mastectomy with immediate reconstruction using smooth implants without additional covering materials. The observation period averages 54.5 months. The incidence of complications, oncological and surgical data, as well as risk factors for removal or replacement of implants are analyzed. Results. Early complications account for 10.94% with most common partial areola necrosis; late complications account for 20.31% mainly as type III–IV capsular contracture according to Baker. In 75% of cases, the implant was retained. High BMI, large implant volume and weight of removed tissue are significant factors in the development of complications. Discussion. The obtained data demonstrate comparable or better results compared to foreign studies. The absence of covering materials and subpectoral placement caused no negative effect on the incidence of infections; however, they correlate with animation deformity. The presence of postoperative radiation therapy significantly increases the risk of contracture. Conclusion. Immediate breast reconstruction using smooth implants demonstrates satisfactory long-term results with a low complication rate. The method can be considered as a safe alternative in conditions of limited access to ADM.

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The authors declare that there are no conflicts of interest present.