Washington, D.C. From the Department of Plastic Surgery, Georgetown University Hospital.
Plast Reconstr Surg. 2008 Aug;122(2):340-347. doi: 10.1097/PRS.0b013e31817d6009.
Breast reconstruction outcome studies typically evaluate satisfaction, complications, or aesthetic results. Some studies report better outcomes with autologous reconstruction, whereas other studies report no difference in outcomes across multiple reconstructive methods.
The authors retrospectively studied all patients undergoing immediate breast reconstruction over a 5-year period. Questionnaires were sent to all patients to assess satisfaction; preoperative bra size, height, and weight; smoking history; radiation history; length of stay; narcotic use; and recovery time. All charts were reviewed for complications. Four blinded reviewers performed aesthetic evaluations of patient results.
One hundred eighty-six consecutive immediate breast reconstruction patients were surveyed. Charts and photographs were reviewed for complication data and aesthetic results. The survey response rate was 42 percent, including 48 of 106 expander/implant patients, 13 of 28 latissimus patients, and 18 of 52 transverse rectus abdominis musculocutaneus (TRAM) flap patients. Patient satisfaction was rated as moderate or better for 93.8 percent of the expander/implant patients, 76.9 percent of the latissimus flap patients, and 83.3 percent of the TRAM flap patients. Expander/implant patients were significantly more satisfied than latissimus flap patients. Complication rates were 21.7 percent for expander/implant patients, 67.9 percent for latissimus flap patients, and 26.9 percent for TRAM flap patients. Reoperation rates were 11.3 percent for expander/implant patients, 10.7 percent for latissimus flap patients, and 5.8 percent for TRAM flap patients. Aesthetic scores were significantly higher for TRAM flap patients compared with expander/implant and latissimus flap patients.
High satisfaction rates were seen across all three reconstructive groups, with the highest satisfaction levels seen in the expander/implant group, despite higher reoperation rates and lower aesthetic scores for this group.
乳房重建的研究结果通常评估满意度、并发症或美学效果。一些研究报告说，自体重建的效果更好，而其他研究则报告说，多种重建方法的结果没有差异。
作者回顾性地研究了 5 年内所有接受即刻乳房重建的患者。向所有患者发送问卷，以评估满意度、术前胸罩尺寸、身高和体重、吸烟史、放疗史、住院时间、使用麻醉药和恢复时间。所有病历均进行并发症复查。四名盲审员对患者的结果进行了美学评估。
对 186 例连续即刻乳房重建患者进行了调查。对病历和照片进行了并发症数据和美学结果的复查。调查的回复率为 42%，其中包括扩张器/植入物患者 48 例、Latissimus 患者 13 例、TRAM 皮瓣患者 18 例。扩张器/植入物患者的满意度评分为 93.8%，Latissimus 皮瓣患者为 76.9%，TRAM 皮瓣患者为 83.3%。扩张器/植入物患者的满意度明显高于 Latissimus 皮瓣患者。扩张器/植入物患者的并发症发生率为 21.7%，Latissimus 皮瓣患者为 67.9%，TRAM 皮瓣患者为 26.9%。扩张器/植入物患者的再次手术率为 11.3%，Latissimus 皮瓣患者为 10.7%，TRAM 皮瓣患者为 5.8%。TRAM 皮瓣患者的美学评分明显高于扩张器/植入物和 Latissimus 皮瓣患者。
所有三组重建患者的满意度均较高，其中扩张器/植入物组的满意度最高，尽管该组的再手术率较高，美学评分较低。
