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Tỷ lệ Biến chứng Trong Các Phương Pháp Khác Nhau Đối Với Sửa Chữa Gynecomastia: Một Phân Tích Hệ Thống Của Tài Liệu

Springer Science and Business Media LLC - Tập 46 - Trang 1025-1041 - 2022

Alessandro Innocenti¹, Dario Melita¹, Emanuela Dreassi²

¹Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy

²Department of Statistica, Informatica, Applicazioni (DiSIA), University of Florence, Florence, Italy

Tóm tắt

Gynecomastia hiện nay là một bệnh lý rất phổ biến, ảnh hưởng đến một lượng lớn bệnh nhân với độ tuổi khác nhau. Mục tiêu của bài tổng quan tài liệu này là để đánh giá tỷ lệ biến chứng của tất cả các kỹ thuật được đề xuất và so sánh các thủ tục kết hợp với các thủ tục đơn lẻ trong việc sửa chữa gynecomastia. Một nghiên cứu tổng quan hệ thống đã được thực hiện để xác định tất cả các kỹ thuật đã được báo cáo trong việc sửa chữa gynecomastia, bao gồm khoảng thời gian từ ngày 1 tháng 1 năm 1987 đến ngày 1 tháng 11 năm 2020. Đối với tất cả các bài báo được chọn, dữ liệu nhân khẩu học, kỹ thuật được đề xuất và tỷ lệ biến chứng đã được ghi nhận. Tổng số 3970 kết quả đã được thu thập từ phân tích cơ sở dữ liệu. Tổng số cuối cùng là 94 bài viết đã được thu thập cho 7294 bệnh nhân đã được phân tích. Bệnh nhân đã được chia thành ba nhóm: kỹ thuật hút, với 874 bệnh nhân (11,98%), kỹ thuật cắt bỏ phẫu thuật, với 2764 bệnh nhân (37,90%), và kỹ thuật kết hợp, với 3656 bệnh nhân (50,12%). Các biến chứng đã được ghi nhận cho tất cả các nhóm, tổng cộng là 1407, trong đó 130 trong nhóm "Kỹ thuật hút" (14,87%), 847 trong nhóm "Kỹ thuật cắt bỏ phẫu thuật" (30,64%), và 430 trong nhóm "Kỹ thuật kết hợp" (11,76%). Nhiều kỹ thuật đã được đề xuất trong tài liệu để đối phó với gynecomastia, với tiềm năng cải thiện tự tin và ngoại hình tổng thể của bệnh nhân bị ảnh hưởng. Việc kết hợp sử dụng kỹ thuật cắt bỏ phẫu thuật và kỹ thuật hút dường như làm giảm tỷ lệ biến chứng so với chỉ cắt bỏ phẫu thuật đơn thuần, nhưng sự thiếu hụt trong phân loại duy nhất và sự hiện diện của nhiều kỹ thuật phẫu thuật vẫn đại diện cho một sự thiên lệch trong tổng quan tài liệu. Tạp chí này yêu cầu tác giả phân bổ mức độ bằng chứng cho từng bài viết. Để biết mô tả đầy đủ về các mức độ Bằng Chứng Y Tế, vui lòng tham khảo Mục Lục hoặc Hướng Dẫn Trực Tuyến cho Tác Giả.

Từ khóa

#gynecomastia #tỷ lệ biến chứng #kỹ thuật phẫu thuật #cắt bỏ phẫu thuật #kỹ thuật hút #tổng quan hệ thống #nghiên cứu y khoa

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Sim N, Tan G, Tan BK, Goh T (2020) Review of the microdebrider excision and liposuction technique (MELT) for the treatment of gynecomastia. J Plast Reconstr Aesthet Surg 73(2):303–312. https://doi.org/10.1016/j.bjps.2019.09.003

Murugesan L, Karidis A (2020) External quilting: new technique to avoid haematoma in gynaecomastia surgery. Aesthetic Plast Surg 44(1):45–51. https://doi.org/10.1007/s00266-019-01537-9

Akhtar A, Eitezaz F, Rashid M, Khan I, Malik SA (2019) Liposuction in gynecomastia: an assessment of the suction-assisted arthroscopic shaver versus open disc excision techniques. Cureus 11(10):e5897. https://doi.org/10.7759/cureus.5897

Tripathy S, Likhyani A, Sharma R, Sharma RK (2020) Prospective analysis and comparison of periareolar excision (delivery) technique and pull-through technique for the treatment of gynecomastia. Aesthet Plast Surg 44(3):653–661. https://doi.org/10.1007/s00266-020-01618-0

Harinatha S (2020) Male gynecomastia correction by superior dynamic flap method: a consistent and versatile technique. World J Plast Surg 9(1):33–38. https://doi.org/10.29252/wjps.9.1.33

Jian C, Wu L, Lin L, Liu W, Zheng Z, Yang C (2020) Single-port endoscopic mastectomy via the lateral chest approach for the treatment of grade II gynecomastia. Med (Baltim) 99(22):e20100. https://doi.org/10.1097/MD.0000000000020100

Qu S, Zhang W, Li S, He W, Lu R, Zhang Q, Zhang J, Wang N (2021) The vacuum-assisted breast biopsy system is an effective strategy for the treatment of gynecomastia. Aesthet Plast Surg 45(2):404–410. https://doi.org/10.1007/s00266-020-01931-8

Pfeiler PP, Luketina R, Dastagir K, Vogt PM, Mett TR, Kaltenborn A, Könneker S (2021) Expected reduction of the nipple-areolar complex over time after treatment of gynecomastia with ultrasound-assisted liposuction mastectomy compared to subcutaneous mastectomy alone. Aesthet Plast Surg 45(2):431–437. https://doi.org/10.1007/s00266-020-02029-x

Innocenti A, Mori F, Melita D, Innocenti M, Ciancio F (2018) Discussion on “reduction of the areolar diameter after ultrasound-assisted liposuction for gynecomastia.” Ann Plast Surg 80(2):193. https://doi.org/10.1097/SAP.0000000000001163

Innocenti A, Melita D, Innocenti M (2018) Re: a novel method to insert drain atraumatically after liposuction in gynecomastia. Indian J Plast Surg. 51(3):342–343

Innocenti A, Melita D (2021) The vacuum-assisted breast biopsy system is an effective strategy for the treatment of gynecomastia. Aesthet Plast Surg. https://doi.org/10.1007/s00266-020-02053-x

Innocenti A, Melita D (2021) Aesthetic outcome of gynecomastia management with conventional liposuction and cross-chest liposuction: a prospective comparative study. Aesthet Plast Surg. https://doi.org/10.1007/s00266-021-02687-5

Innocenti A, Serena G, Innocenti M (2021) External quilting: new technique to avoid haematoma in gynaecomastia surgery. Aesthet Plast Surg 45(2):831–832

Innocenti A (2019) Male tuberous breast: a rare variant of gynecomastia. Clinical considerations and personal experience: tips and tricks to maximize surgical outcomes. Aesthet Plast Surg 43(6):1500–1505

Innocenti A, Ghezzi S, Innocenti M (2019) Correction of tuberous nipple areolar complex deformity in gynecomastia: the deformity that can get forgotten. Ann Plast Surg 83(3):367

Innocenti A, Melita D (2021) Percutaneous intradermal purse-string closure for correction of male tuberous nipple-areola complex deformity. Aesthet Plast Surg. https://doi.org/10.1007/s00266-021-02591-y

Innocenti A, Ciancio F, Parisi D, Portincasa A, Melita D, Innocenti M (2017) Comment to “orange peel excision of gland: a novel surgical technique for treatment of gynecomastia.” Ann Plast Surg 79(3):326

Innocenti A, Ghezzi S, Melita D (2020) Commentary on “surgical treatment of gynaecomastia: a standard of care in plastic surgery” by Tobias R. Mett, Peter P. Pfeiler, Rosalia Luketina, Alperen S. Bingöl, Nicco Krezdorn & Peter M. Vogt. Eur J Plast Surg 43(5): 1-2

Innocenti A, Ghezzi S, Melita D, Ciancio F, Innocenti, (2018) Comment to: “complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database.” Aesthet Plast Surg 42(1):334–335

Innocenti A, Ciancio F, Portincasa A, Parisi D (2017) Discussion: surgical management of gynecomastia-subcutaneous mastectomy and liposuction. Aesthet Plast Surg 41(4):983–984

Innocenti A, Melita D (2021) Expected reduction of the nipple-areolar complex over time after treatment of gynecomastia with ultrasound-assisted liposuction mastectomy compared to subcutaneous mastectomy alone. Aesthet Plast Surg 45(3):1350–1351

Innocenti A, Melita D, Mori F, Ciancio F, Innocenti M (2017) Reply to the comment on: management of gynecomastia in patients with different body types: considerations on 312 consecutive treated cases. Ann Plast Surg 79(2):226–227

Innocenti A, Ghezzi S, Melita D, Innocenti M (2018) Clinical characteristics of asymmetric bilateral gynecomastia: suggestion of desirable surgical method based on a single-institution experience. Aesthet Plast Surg 42(6):1716–1717

Innocenti A, Melita D, Ciancio F, Innocenti M (2017) Discussion: “long-term follow-up of recurrence and patient satisfaction after surgical treatment of gynecomastia.” Aesthet Plast Surg 41(5):1242–1243. https://doi.org/10.1007/s00266-017-0866-3

Innocenti A, Melita D, Mori F, Ciancio F, Innocenti M (2017) Comment to “postero-inferior pedicle surgical technique for the treatment of grade III gynecomastia.” Aesthet Plast Surg 41(3):747–748. https://doi.org/10.1007/s00266-017-0849-4

Innocenti A, Melita D, Innocenti M (2018) Evaluation of glandular liposculpture as a single treatment for grades I and II gynecomastia. Aesthet Plast Surg 42(6):1707–1708. https://doi.org/10.1007/s00266-018-1156-4

Innocenti A, Melita D, Ghezzi S (2019) Closed-suction drains after subcutaneous mastectomy for gynecomastia: do they reduce complications? Aesthet Plast Surg 43(4):1124–1125. https://doi.org/10.1007/s00266-017-1060-3

Ciancio F, Innocenti A, Parisi D, Portincasa A (2017) Gynecomastia -classification for surgical management: a systematic review and novel classification system. Plast Reconstr Surg 140(4):620e–621e

Innocenti A, Ghezzi S, Melita D, Innocenti M (2017) Comment on: “surgical masculinization of the breast: clinical classification and surgical procedures.” Aesthet Plast Surg 41(6):1475–1476

Innocenti A, Melita D, Ghezzi S, Ciancio F, Innocenti M (2017) Comment to: “the characteristics and short-term surgical outcomes of adolescent gynecomastia.” Aesthet Plast Surg 41(6):1467–1468

Innocenti A, Melita D (2021) Patients decision-making characteristics affects gynecomastia treatment satisfaction: a multicenter study using the BODY-Q chest module. Aesthet Plast Surg. https://doi.org/10.1007/s00266-021-02688-4

Innocenti A, Melita D (2021) Endoscopic axillary approach improves patient satisfaction of gynecomastia subcutaneous mastectomy: a cross-sectional study using the BODY-Q chest module. Aesthet Plast Surg. https://doi.org/10.1007/s00266-020-02086-2

Innocenti A, Melita D, Mori F, Innocenti M, Ciancio F (2018) Discussion on “gynecomastia surgery-impact on life quality: a prospective case-control study.” Ann Plast Surg 80(2):193–194. https://doi.org/10.1097/SAP.0000000000001172

Melita D, Innocenti A (2020) Prospective analysis and comparison of periareolar excision (delivery) and pull-through technique for the treatment of gynecomastia. Aesthet Plast Surg 44(3):1089–1090. https://doi.org/10.1007/s00266-020-01676-4

Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G (2015) Gynecomastia: a systematic review. J Plast Surg Hand Surg 49(6):311–318. https://doi.org/10.3109/2000656X.2015.1053398

Innocenti A, Melita D, Innocenti M (2021) Gynecomastia and chest masculinization: an updated comprehensive reconstructive algorithm. Aesthet Plast Surg 45(5):2118–2126. https://doi.org/10.1007/s00266-021-02275-7

Barone M, Cogliandro A, Tsangaris E, Salzillo R, Morelli Coppola M, Ciarrocchi S, Brunetti B, Tenna S, Tambone V, Persichetti P (2018) Treatment of severe gynecomastia after massive weight loss: analysis of long-term outcomes measured with the italian version of the BODY-Q. Aesthet Plast Surg 42(6):1506–1518. https://doi.org/10.1007/s00266-018-1232-9

Barone M, Cogliandro A, Persichetti P (2019) Innovative technique to improve chest shape following gynecomastia correction in post-bariatric surgery patients. Plast Reconstr Surg 144(2):324e–325e. https://doi.org/10.1097/PRS.0000000000005819

Innocenti A, Ciancio F, Francesco M, Melita D, Innocenti M (2017) Comment to “no-drain single incision liposuction pull-through technique for gynecomastia.” Aesthet Plast Surg 41(4):990–991. https://doi.org/10.1007/s00266-017-0821-3

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