埼玉医科大学雑誌 第32巻 第2号 (2005年4月) 45-50頁 ◇論文(図表を含む全文)は，PDFファイルとなっています．
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山口 悟，原科 孝雄，Jean Yves Petit＊
Evaluation of Skin Perfusion After Nipple-Sparing Mastectomy by Indocyanine Green Dye
Satoru Yamaguchi, Takao Harashina, Jean Yves Petit＊ (Department of Plastic and Reconstructive Surgery, Saitama Medical Center, Kawagoe, Saitama 350-8550, Japan, ＊Department of Plastic and Reconstructive Surgery European Institute of Oncology, Milan, Italy)
The aim of this study is to investigate the blood supply of the normal nipple-areola complex (NAC) and the spared nipple-areola complex after a nipple-sparing mastectomy by the analysis of the fluorescence resulting from the indocyanine green dye (ICG) injection. At European Institute of Oncology (Milan, Italy), the nipple-sparing mastectomy is a subcutaneous mastectomy which spares a small glandular tissue underneath the areola to preserve the blood supply of the NAC, associated with intraoperative radiotherapy of the remaining glandular tissue. From December 2002 to July 2003 we performed the ICG analyses in 10 monolateral nipple-sparing mastectomy cases (10 healthy breasts and 10 postoperative breasts). In all cases, the resulting fluorescence was registered in three different zones: surrounding mammary skin, areola, and nipple. The slope of the each fluorescence curve was measured. On the healthy breast, the nipple showed a very high perfusion compared with other zones. On the contrary, after the mastectomy the fluorescent pattern was completely altered, being the perfusion of the nipple very low. The perfusion of the surrounding mammary skin was not so changed after surgery. Even more, the perfusion was superior than the healthy breast. In conclusion, these preliminary cases confirm the applicability of the ICG technique to evaluate the perfusion of the healthy and spared nipple-areola complex after surgery. In the future, we can apply this technique to estimate the future-results just after a nipple-sparing mastectomy to avoid NAC necrosis and hypoprojection of the nipple.