Saulis Alexandrina S, Mustoe Thomas A, Fine Neil A
Chicago, Ill. From the Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine.
Plast Reconstr Surg. 2007 May;119(6):1669-1676. doi: 10.1097/01.prs.0000258827.21635.84.
The authors aimed to quantify overall patient satisfaction with three breast reconstruction techniques and identify factors that have influenced satisfaction.
Two hundred sixty-eight questionnaires were mailed at least 6 months after immediate breast reconstruction to consecutive breast reconstruction patients over a 3-year period. A second questionnaire was sent out 9 months later to the tissue expander/implant group of patients.
The initial questionnaire demonstrated that overall satisfaction was significantly greater in the transverse rectus abdominis myocutaneous (TRAM) flap patients as compared with the tissue expander/implant patients (p < 0.05). However, the number of patients willing to repeat the procedure and recommend their procedure to a friend was similar among all three reconstructive techniques. A significantly greater number of tissue expander/implant patients as compared with TRAM flap patients felt they had not received sufficient information to make an educated decision (p < 0.05). This finding correlated with the lower satisfaction rate among the tissue expander/implant patients. The second questionnaire sent only to the tissue expander/implant patients revealed that the majority felt uninformed about the final aesthetic outcome and the frequency and pain associated with the expansion process.
All three groups may claim to be satisfied with their own personal choices. Many patients will continue to choose tissue expander/implant reconstruction in an effort to avoid scars and more extensive surgery. Being less satisfied is not wrong or bad, provided it is known. Tissue expander/implant patients should be thoroughly informed in the preoperative setting about the final aesthetic outcomes and the immediate perioperative expansion period, which may involve a considerable amount of patient commitment and discomfort in some women.
作者旨在量化患者对三种乳房重建技术的总体满意度，并确定影响满意度的因素。
在3年时间里，对连续接受即刻乳房重建的患者在乳房重建后至少6个月邮寄了268份问卷。9个月后，向组织扩张器/植入物组的患者发送了第二份问卷。
初始问卷显示，与组织扩张器/植入物组患者相比，横行腹直肌肌皮瓣（TRAM瓣）患者的总体满意度显著更高（p < 0.05）。然而，在所有三种重建技术中，愿意重复该手术并向朋友推荐该手术的患者人数相似。与TRAM瓣患者相比，组织扩张器/植入物组患者中感觉自己没有获得足够信息来做出明智决定的人数显著更多（p < 0.05）。这一发现与组织扩张器/植入物组患者较低的满意度相关。仅发送给组织扩张器/植入物组患者的第二份问卷显示，大多数患者对最终美学效果以及与扩张过程相关的频率和疼痛了解不足。
所有三组患者都可能声称对自己的个人选择感到满意。许多患者将继续选择组织扩张器/植入物重建，以避免留下疤痕和进行更广泛的手术。只要知晓，满意度较低并非错误或不好。对于组织扩张器/植入物组患者，术前应充分告知其最终美学效果以及围手术期即刻扩张期的情况，这在一些女性患者中可能需要患者付出相当多的努力并承受不适。
