Ménez T, Michot A, Tamburino S, Weigert R, Pinsolle V
Service de chirurgie plastique, reconstructrice et esthétique, service des brûlés et chirurgie de la main, centre François-Xavier-Michelet, groupe hospitalier Pellegrin, université Bordeaux-Segalen, 33000 Bordeaux, France.
Department of plastic and reconstructive surgery, Cannizzaro hospital, university of Catania, Catania, Italy.
Ann Chir Plast Esthet. 2018 Apr;63(2):126-133. doi: 10.1016/j.anplas.2017.07.022. Epub 2017 Aug 25.
Breast reconstruction techniques are multiple and they should be chosen in order to improve women's satisfaction and well-being, thus obtaining a personalized treatment. This report's major purpose was to study, through the Breast-Q questionnaire, how the functional and aesthetic outcomes, as well as the complications, of the main autologous breast reconstruction techniques, can affect patients quality of life and well-being at long-term. The secondary purpose was to analyse, thus to identify, the independent factors characterizing the different reconstructive techniques, which may affect patients' satisfaction.
Women who underwent autologous breast reconstruction through deep inferior epigastric artery perforator or Latissimus dorsi muscle flap from May 2006 to May 2013 were included. The assessment was based on the Breast-Q reconstruction questionnaire. All times of post-mastectomy reconstruction were concerned: immediate, delayed, after previous procedure failure or conversion to another reconstructive technique due to the patient's dissatisfaction.
A total of 98 patients were included. Concerning patients satisfaction, the breast-Q score is highest in patients who underwent immediate breast reconstruction, while scores after delayed breast reconstruction, previous surgery failure or conversion to another technique are generally equivalent. Higher scores have been observed in patients who underwent reconstruction through autologous Latissimus dorsi compared to Latissimus dorsi with prosthetic implant reconstruction.
The authors identified factors of higher patients' satisfaction, like absence of major complication and advanced patient's age, in order to personalize the surgical planning according to the patient's priorities.
乳房重建技术多种多样,应根据提高女性满意度和幸福感的原则进行选择,从而实现个性化治疗。本报告的主要目的是通过乳房Q问卷研究主要自体乳房重建技术的功能和美学效果以及并发症如何长期影响患者的生活质量和幸福感。次要目的是分析并确定不同重建技术的独立特征因素,这些因素可能影响患者的满意度。
纳入2006年5月至2013年5月期间通过腹壁下深动脉穿支或背阔肌肌皮瓣进行自体乳房重建的女性。评估基于乳房Q重建问卷。涵盖乳房切除术后重建的所有时间点:即刻、延迟、先前手术失败后或因患者不满而转换为另一种重建技术后。
共纳入98例患者。关于患者满意度,接受即刻乳房重建的患者乳房Q评分最高,而延迟乳房重建、先前手术失败或转换为另一种技术后的评分通常相当。与背阔肌假体植入重建相比,接受自体背阔肌重建的患者评分更高。
作者确定了患者满意度较高的因素,如无重大并发症和患者年龄较大,以便根据患者的优先事项个性化手术规划。