Objective. To study the possibilities of using nanotextured implants in performing subcutaneous and skin-sparing mastectomy with one-stage reconstruction using an endoprosthesis (direct-to-implant, DTI) in patients with breast cancer. Material and methods. Over a period of 5 months, 35 nanotextured implants were installed in 35 cases of primary surgeries in patients with breast cancer. The mean age of the patients was 40.3 years. Subcutaneous mastectomy was performed in 25 (71%) cases, skin-sparing mastectomy in 10 (29%). A total of 35 implants were placed: Round Silk in 80% (n=28) of cases, Ergonomix in 20% (n=7). In 28 patients (80%), the implant was placed prepectorally, and in 7 (20%), a submuscular pocket was created in combination with a Tiloop bra mesh implant. Results. In no case were postoperative hematomas or ischemic disorders observed in the area of skin flaps and the nipple-areolar complex. The highest complication rate was observed in the group of patients receiving adjuvant radiation therapy. Radiation therapy was administered to 23 patients (66%). Seroma occurred in 7 cases (20%), 3 of which were infected. Implant loss occurred in 5 patients (14%), all preceded by seroma. Capsular contracture following radiation therapy was observed in 11 cases (31%). Conclusion. The obtained data indicate that adjuvant radiation therapy is the most significant risk factor for the development of complications with prepectoral implant placement (performed in 80% of cases), which dictates the need for a thorough assessment of the indications for radiation therapy and modification of surgical techniques and methods of operations, which require further study as part of multicenter and long-term studies.
Troshenkov et al. (Thu,) studied this question.