Gonzalez Marco A, Glickman Laurence T, Aladegbami Bola, Simpson Roger L
Long Island Plastic Surgical Group, Division of Plastic and Reconstructive Surgery, Nassau University Medical Center, Garden City, NY 11530, USA.
Ann Plast Surg. 2012 Oct;69(4):361-3. doi: 10.1097/SAP.0b013e31824a218a.
Patient reported outcome studies are extremely valuable. We hypothesize that breast reduction surgery has a high satisfaction rate, and that body mass index (BMI), and the amount of breast tissue removed would not alter this outcome. The purpose of this study was to determine if there is an improvement in the quality of life in patients undergoing breast reduction surgery, and whether breast volume or patient size influences this outcome.
A retrospective chart review was performed on 600 consecutive patients at a single institution from 2000 to 2010. Patients were mailed The Breast Q questionnaire to complete. Demographic, surgical, and clinical data were collected and entered into a database. Descriptive statistical analyses were conducted using SAS Software version 9.1.3 with statistical significance determined at P<0.05.
A total of 178 surveys were returned and included in our study (a response rate of 29.6%). Patient data included a mean BMI of 28.3 (4.6) kg/m, and mean total amount of breast tissue removed of 1220.9 (665.4) g. The primary indications for patients having breast surgery were for symptomatic macromastia (85%), asymmetry (5.6%), and for cosmesis (2.5%). The Breast Q questionnaire demonstrated patients overwhelmingly agreed that they were satisfied with their breast surgery. The mean response was 2.8 with a standard deviation (SD) of 0.47 (where 1, disagree; 2, somewhat agree; and 3, definitely agree). Patient BMI and total amount of breast tissue removed had a statistically significant positive correlation (0.479; P<0.0001). There was no statistically significant difference between the amount of total breast tissue removed and patient response (P=0.57).
The study supports a positive outcome after breast reduction surgery. Over 95% of the patients surveyed were satisfied and would do it again. It demonstrates the improvement of the patient's quality of life regardless of the amount of breast tissue removed. Furthermore, it suggests that the size and weight of the patient has no impact on this outcome. As we face new government and insurance restrictions for surgeries that have both cosmetic and reconstructive value, patient reported outcome studies may have an influence on future third-party payer.
患者报告的结局研究极具价值。我们假设乳房缩小手术的满意度很高，且体重指数（BMI）和切除的乳腺组织量不会改变这一结果。本研究的目的是确定接受乳房缩小手术的患者生活质量是否有所改善，以及乳房体积或患者体型是否会影响这一结果。
对2000年至2010年在一家机构连续就诊的600例患者进行回顾性病历审查。向患者邮寄《乳房问卷》以供填写。收集人口统计学、手术和临床数据并录入数据库。使用SAS软件9.1.3进行描述性统计分析，以P<0.05确定统计学意义。
共收回178份调查问卷并纳入我们的研究（回复率为29.6%）。患者数据包括平均BMI为28.3（4.6）kg/m²，平均切除的乳腺组织总量为1220.9（665.4）g。患者进行乳房手术的主要指征是有症状的巨乳症（85%）、不对称（5.6%）和美容需求（2.5%）。《乳房问卷》显示，患者压倒性地表示对乳房手术满意。平均回复为2.8，标准差（SD）为0.47（其中1表示不同意；2表示 somewhat同意；3表示肯定同意）。患者BMI与切除的乳腺组织总量呈统计学显著正相关（0.479；P<0.0001）。切除的乳腺组织总量与患者回复之间无统计学显著差异（P=0.57）。
该研究支持乳房缩小手术后的积极结果。超过95%的接受调查患者表示满意，愿意再次接受手术。这表明无论切除的乳腺组织量多少，患者的生活质量都有所改善。此外，这表明患者的体型和体重对这一结果没有影响。随着我们面临对具有美容和重建价值手术的新的政府和保险限制，患者报告的结局研究可能会对未来的第三方支付方产生影响。
