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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rpmj</journal-id><journal-title-group><journal-title xml:lang="ru">Research'n Practical Medicine Journal</journal-title><trans-title-group xml:lang="en"><trans-title>Research and Practical Medicine Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2410-1893</issn><publisher><publisher-name>"QUASAR", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17709/2409-2231-2020-7-3-6</article-id><article-id custom-type="elpub" pub-id-type="custom">rpmj-589</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Review</subject></subj-group></article-categories><title-group><article-title>Препекторальная установка полиуретанового имплантата после подкожной мастэктомии у больных раком молочной железы</article-title><trans-title-group xml:lang="en"><trans-title>Prepectoral reconstruction with polyurethane-coated implant after skin-sparing mastectomy in patients with breast cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7502-2288</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Власова</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Vlasova</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Власова Мария Юрьевна – аспирант кафедры онкологии и реконструктивной хирургии лечебного факультета; врач-онколог </p><p>119991, г. Москва, ул. Трубецкая, д. 8, стр. 2</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 5411-7671</p><p>AuthorID: 1069492</p></bio><bio xml:lang="en"><p>Maria Yu. Vlasova – postgraduate student of the department of oncology and reconstructive surgery of the medical faculty; oncoligist </p><p>8/2 Trubetskaya str., Moscow 119991</p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 5411-7671</p><p>AuthorID: 1069492 </p></bio><email xlink:type="simple">vlasova_maria2092@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7141-2502</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зикиряходжаев</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Zikiryakhodzhaev</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зикиряходжаев Азиз Дильшодович – д.м.н., руководитель отделения реконструктивно-пластической хирургии молочной железы и кожи; доцент кафедры онкологии и реконструктивной хирургии лечебного факультета </p><p>119991, г. Москва, ул. Трубецкая, д. 8, стр. 2</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 8421-0364</p><p>AuthorID: 701248</p></bio><bio xml:lang="en"><p>Aziz D. Zikiryakhodzhaev – Dr. Sci. (Med.), head of the department of breast and skin reconstructive plastic surgery; associate Professor of the department of oncology and reconstructive surgery of the medical faculty </p><p>8/2 Trubetskaya str., Moscow 119991</p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 8421-0364</p><p>AuthorID: 701248 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3888-8004</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Решетов</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Reshetov</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Решетов Игорь Владимирович – академик РАН, д.м.н., заведующий кафедрой онкологии и реконструктивной хирургии лечебного факультета</p><p>119991, г. Москва, ул. Трубецкая, д. 8, стр. 2</p><p>SPIN: 3845-6604</p><p>AuthorID: 103745</p></bio><bio xml:lang="en"><p>Igor V. Reshetov – Dr. Sci. (Med.), academician of the Russian Academy of Sciences, head of the department of oncology and reconstructive surgery of the medical faculty </p><p>8/2 Trubetskaya str., Moscow 119991</p><p>SPIN: 3845-6604</p><p>AuthorID: 103745 </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2337-5919</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сухотько</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Sukhotko</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сухотько Анна Сергеевна – к.м.н., врач-онколог</p><p>109044, г. Москва, ул. Воронцовская, д. 8, стр. 6</p><p>SPIN: 2391-6469</p><p>AuthorID: 812052</p></bio><bio xml:lang="en"><p>Anna S. Sukhotko – Cand. Sci. (Med.), oncologist </p><p>8/6 Vorontsovskaya str., Moscow 109044</p><p>SPIN-код: 2391-6469</p><p>AuthorID: 812052 </p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1559-1304</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сарибекян</surname><given-names>Э. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Saribekyan</surname><given-names>E. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сарибекян Эрик Карлович – д.м.н., ведущий научный сотрудник отделения реконструктивно-пластической хирургии молочной железы и кожи</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 3491-0586</p><p>AuthorID: 722452</p></bio><bio xml:lang="en"><p>Erik K. Saribekyan – Dr. Sci. (Med.), leading researcher of the department of breast and skin reconstructive plastic surgery</p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 3491-0586</p><p>AuthorID: 722452 </p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9510-1434</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Усов</surname><given-names>Ф. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Usov</surname><given-names>F. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Усов Федор Николаевич – к.м.н., врач-онколог отделения реконструктивно-пластической хирургии молочной железы и кожи</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 9254-2294</p><p>AuthorID: 778307</p></bio><bio xml:lang="en"><p>Fedor N. Usov – Cand. Sci. (Med.), oncologist of the department of breast and skin reconstructive plastic surgery </p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 9254-2294</p><p>AuthorID: 778307 </p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1742-3205</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Широких</surname><given-names>И. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Shirokikh</surname><given-names>I. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Широких Ирина Михайловна – к.м.н., научный сотрудник отделения реконструктивно-пластической хирургии молочной железы и кожи</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 2577-4539</p><p>AuthorID: 885003</p></bio><bio xml:lang="en"><p>Irina M. Shirokikh – Cand. Sci. (Med.), researcher of the department of breast and skin reconstructive plastic surgery </p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 2577-4539</p><p>AuthorID: 885003 </p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7261-8956</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бересток</surname><given-names>Т. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Berestok</surname><given-names>T. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бересток Татьяна Сергеевна – аспирант кафедры онкологии и реконструктивной хирургии лечебного факультета; врач-хирург-онколог общеклинического отдела </p><p>119991, г. Москва, ул. Трубецкая, д. 8, стр. 2</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 2868-2950</p><p>AuthorID: 1065159</p></bio><bio xml:lang="en"><p>Tatiana S. Berestok – postgraduate student of the department of oncology and reconstructive surgery of the medical faculty; surgeon-oncologist of the general clinical department </p><p>8/2 Trubetskaya str., Moscow 119991</p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 2868-2950</p><p>AuthorID: 1065159 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8569-626X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трегубова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tregubova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Трегубова Анна Викторовна – аспирант</p><p>125284, г. Москва, 2-й Боткинский проезд, д. 3</p><p>SPIN: 1310-1477</p><p>AuthorID: 999984</p></bio><bio xml:lang="en"><p>Anna V. Tregubova – graduate student </p><p>3 2nd Botkinskiy travel, Moscow 125284</p><p>SPIN: 1310-1477, </p><p>AuthorID: 999984 </p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый МГМУ им. И.М.Сеченова» Министерства здравоохранения Российской Федерации; МНИОИ им. П.А.Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M.Sechenov First Moscow State Medical University; P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый МГМУ им. И.М.Сеченова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M.Sechenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Клиника «Медицинский центр ОН КЛИНИК на Таганке»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>ON CLINIC Medical Center on Taganka</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>МНИОИ им. П.А.Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>11</day><month>09</month><year>2020</year></pub-date><volume>7</volume><issue>3</issue><fpage>63</fpage><lpage>73</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Власова М.Ю., Зикиряходжаев А.Д., Решетов И.В., Сухотько А.С., Сарибекян Э.К., Усов Ф.Н., Широких И.М., Бересток Т.С., Трегубова А.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Власова М.Ю., Зикиряходжаев А.Д., Решетов И.В., Сухотько А.С., Сарибекян Э.К., Усов Ф.Н., Широких И.М., Бересток Т.С., Трегубова А.В.</copyright-holder><copyright-holder xml:lang="en">Vlasova M.Y., Zikiryakhodzhaev A.D., Reshetov I.V., Sukhotko A.S., Saribekyan E.K., Usov F.N., Shirokikh I.M., Berestok T.S., Tregubova A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpmj.ru/rpmj/article/view/589">https://www.rpmj.ru/rpmj/article/view/589</self-uri><abstract><p>Не смотря на успехи ранней диагностики, рак молочной железы (РМЖ) является одним из наиболее часто диагностируемых злокачественных новообразований (ЗНО) Российской Федерации (РФ), составляя в структуре женского населения 20,9%. Хирургический метод остается основным в лечении онкопатологии молочной железы. Развитие и совершенствование различных вариантов реконструктивно-пластических операций обеспечивает медицинскую, психологическую и социальную реабилитацию больных РМЖ, позволяя добиться наилучших эстетических и функциональных результатов. Возможность выполнения такого рода операций cпособствует улучшению качества жизни пациенток. По данным ASPS (American Society of Plastic Surgeons) 80% реконструкций молочной железы по поводу рака в мире выполняют с применением силиконовых эндопротезов. В настоящее время появилась тенденция к возвращению препекторального пространства для размещения эндопротезов при реконструкциях молочных желез, что связано не только с усовершенствованием методик мастэктомии, но и покрытия имплантатов и появлением силиконового высококогезивного гелевого наполнения имплантатов. Применение при препекторальной/подкожной реконструкции эндопротезов с полиуретановым покрытием, по данным мировой литературы, снижает риск развития капсулярной контрактуры, обеспечивает более надежную фиксацию к окружающим тканям и тем самым позволяет выполнить реконструкцию молочных желез без необходимости дополнительного укрытия эндопротеза. Использование препекторального пространства характеризуется более простой техникой операции по сравнению с ретромускулярным расположением имплантата, отсутствием повреждения большой грудной мышцы, минимизацией болевого синдрома, сокращением койко-дня в стационаре и более быстрым реабилитационным периодом. Таким образом, данный вид реконструкции молочных желез может рассматриваться в качестве альтернативы субмускулярному расположению эндопротеза при первично-операбельных формах РМЖ при достаточной толщине покровных тканей.</p></abstract><trans-abstract xml:lang="en"><p>Breast cancer is one of the most frequently diagnosed malignancies in the Russian Federation (RF), accounting for 20.9% of the female population in Russia. The surgery remains the primary treatment for breast cancer. Development and improvement of various options for reconstructive plastic surgery provides medical, psychological and social rehabilitation in patients with breast cancer, allows to achieve the best aesthetic and functional results. The possibility of performing such operations contributes to improving the quality of life of patients. According to ASPS (American Society of Plastic Surgeons), 80% of breast cancer reconstructions in the world are performed using silicone implants. Currently, the return of prepectoral space for placement of endoprostheses during breast reconstruction is trending, which is associated not only with the improvement of mastectomy techniques, but also with the coating of implants and the appearance of silicone highly adhesive gel filling of implants. According to the world literature data, the use of polyurethane-coated endoprostheses for prepectoral/subcutaneous reconstruction reduces the risk of capsular contracture, provides a more reliable fixation to the surrounding tissues, and thus allows breast reconstruction without the need for additional cover of the endoprosthesis. The use of the prepectoral space is characterized by a simpler operation technique compared to the retromuscular placement of the implant, the absence of damage to the large pectoral muscle, minimization of pain, reduction of the bed-day in the hospital and a faster rehabilitation period. So, this type of breast reconstruction can be considered as an alternative to submuscular implant placement in primary operable forms of breast cancer with sufficient thickness of the integumentary tissues.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>препекторальная/подкожная реконструкция</kwd><kwd>имплантаты с полиуретановым покрытием</kwd><kwd>одномоментная реконструкция при раке молочной железы</kwd><kwd>силиконовые эндопротезы</kwd><kwd>подкожная/кожесохранная мастэктомия</kwd><kwd>реконструктивно-пластическая хирургия молочной железы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>prepectoral/subcutaneous reconstruction</kwd><kwd>polyurethane-coated implants</kwd><kwd>single-stage reconstruction for breast cancer</kwd><kwd>silicone implants</kwd><kwd>skin-sparing/skin-preserving mastectomy</kwd><kwd>breast reconstructive plastic surgery</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Heimes A-S, Stewen K, Hasenburg A. 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