乳头延迟 (ND) 是一种分阶段手术，可改善 NAC 或皮瓣坏死高风险的保留乳头乳房切除术 (NSM) 患者的乳头乳晕复合体 (NAC) 活力。本研究比较了 ND-NSM 和单独 NSM 治疗的患者的术后结果和危险因素。比较了 2009 年至 2009 年 ND-NSM 组和 NSM 组之间的患者人口统计学、NAC 或皮瓣坏死的危险因素、肿瘤特征和手术结果。 2023.进行单变量和多变量分析以确定与 NAC 或皮瓣坏死相关的显着变量。总体而言，对 71 名 ND-NSM 患者和 537 名 NSM 患者进行了比较。 ND-NSM 患者乳房较大 (p < 0.01)、体重指数 ≥30 (p = 0.01)、既往乳房/胸壁放射 (XRT) [p < 0.01]、既往乳房手术 (p < 0.01)、腋窝较少与 NSM 患者相比，手术（p < 0.01）、更多的自体组织重建（p = 0.02）和更多的预防（p < 0.01）。各组之间在感染、皮瓣坏死、NAC坏死、血清肿和血肿方面没有统计学上的显着差异。 ND-NSM 组中没有患者出现 NAC 坏死，1 例患者出现皮瓣坏死，而 NSM 组中分别有 17 例和 13 例患者出现皮瓣坏死 (p = 0.24)。在单变量分析中，既往 XRT 与皮瓣坏死风险增加相关 (p = 0.02)。多变量分析显示 XRT 与皮瓣坏死 (p = 0.02) 和任何坏死 (p = 0.01) 相关。乳房大小与 NAC 或皮瓣坏死相关 (p = 0.04)。较大的乳房和 XRT 是 NAC 或皮瓣坏死的危险因素；然而，尽管有更多的危险因素，ND-NSM 患者的坏死率非常低。值得注意的是，没有乳头丢失。应与患者就 ND-NSM 的风险和益处做出共同决定。© 2024。作者。

Nipple delay (ND) is a staged procedure that improves nipple-areolar complex (NAC) viability in nipple-sparing mastectomy (NSM) patients who are high-risk for NAC or skin-flap necrosis. This study compared postoperative outcomes and risk factors between patients treated with ND-NSM and NSM alone.Patient demographics, risk factors for NAC or skin-flap necrosis, tumor characteristics, and operative outcomes were compared between ND-NSM and NSM groups from 2009 to 2023. Univariate and multivariate analyses were performed to identify significant variables associated with NAC or skin-flap necrosis.Overall, 71 ND-NSM patients and 537 NSM patients were compared. ND-NSM patients had larger breasts (p < 0.01), body mass index ≥ 30 (p = 0.01), prior breast/chest wall radiation (XRT) [p < 0.01], prior breast operations (p < 0.01), less axillary surgery (p < 0.01), more autologous tissue reconstruction over implant-based reconstruction compared with NSM patients (p = 0.02), and more prophylaxis (p < 0.01). There were no statistically significant differences between groups in regard to infection, skin-flap necrosis, NAC necrosis, seromas, and hematomas. No patients in the ND-NSM group had NAC necrosis and 1 patient had skin-flap necrosis, compared with 17 and 13 patients in the NSM group, respectively (p = 0.24). On univariate analysis, prior XRT was associated with increased risk for skin-flap necrosis (p = 0.02). Multivariate analysis showed XRT was associated with skin-flap necrosis (p = 0.02) and any necrosis (p = 0.01). Breast size was associated with NAC or skin-flap necrosis (p = 0.04).Larger breasts and XRT were risk factors for NAC or skin-flap necrosis; however, despite having more risk factors, ND-NSM patients had very low rates of necrosis. Notably, no nipples were lost. A shared decision should be made with patients regarding the risks and benefits of ND-NSM.© 2024. The Author(s).