2018 Fiscal Year Final Research Report

Clinical and basic research of implantation of free dermal fat graft for breast cancer patients

Research Project

PDF

Project/Area Number	16K10465
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	General surgery
Research Institution	Fujita Health University (2018) Kagoshima University (2016-2017)
Principal Investigator	Kijima Yuko 藤田医科大学, 医学部, 教授 (60381175)
Co-Investigator(Kenkyū-buntansha)	平田宗嗣鹿児島大学, 附属病院, 医員 (00649072) 中条哲浩鹿児島大学, 医歯学域附属病院, 講師 (20404486) 新田吉陽鹿児島大学, 附属病院, 医員 (20725733) 夏越祥次鹿児島大学, 医歯学域医学系, 教授 (70237577) 有馬豪男鹿児島大学, 医歯学域附属病院, 助教 (90418856)
Project Period (FY)	2016-04-01 – 2019-03-31
Keywords	乳癌 / 乳房温存手術 / 整容性 / 遊離真皮脂肪片 / 乳房縮小手術
Outline of Final Research Achievements	We implanted FDFG for patients with early breast cancer on upper-inner quadrant area indicative for breast conserving surgery followed by immediate breast reshaping using FDFG. According our former research (Kijima Y, et al. JPRAS 2007)(Kijima Y, et al. Gland Surgery 2015), caused of perioperative complications resulted in those two factors. First is host factor (smoking) and a clinical factor (experience of the practiced hand, operative time, intraoperative bleeding, size of the free dermal fat graft, resected breast size). In clinical practice, we selected adequate patients for breast conserving surgery followed by immediate FDFG implantation. So that, it was difficult to find out any patients group adequate for FDFG with CAL or platelet. On the other hand, it became clear that volume replacement for patients without ptotic breasts using FDFG or thoracodorsal adipofascial cutaneous flap, and volume displacement for patients with ptotic breasts are also useful for Japanese patients.
Free Research Field	乳腺外科
Academic Significance and Societal Importance of the Research Achievements	対象症例での周術期合併症について，多施設共同研究では周術期合併症のリスクファクターとして宿主因子（喫煙）および臨床因子（術者の経験，手術時間，術中出血量，移植片のサイズ，摘出乳腺サイズ）があげられた（Kijima et al. Gland Surgery 2015）.実臨床ではこれらの明らかになったリスクを回避した症例を抽出して患者選を行ったため本手技による優越性を見出すことは困難であった．.同時期に実施した整容性を考慮した乳房温存術時の手術介入については，乳房下垂の有無別に実施したvolume replacement，volume displacementが有用であることが明らかとなった．