Hammer-Hansen Niels, Juhl Alexander Andersen, Damsgaard Tine Engberg
a Plastic Surgery Research Unit, Department of Plastic and Breast Surgery , Aarhus University Hospital , Aarhus , Denmark.
J Plast Surg Hand Surg. 2018 Jun;52(3):158-162. doi: 10.1080/2000656X.2017.1372289. Epub 2017 Aug 30.
Necrosis in implant-based immediate breast reconstruction is a feared complication. Accurate evaluation of mastectomy skin flaps per-operatively is necessary to decrease this risk. The present study is the first in Scandinavia to review the effects of perioperative evaluation with laser-assisted indocyanine green fluorescence angiography (LA-ICGA).
A retrospective review was performed using data from the electronic patient record at the Department of Plastic and Breast Surgery at Aarhus University Hospital in Denmark on all patients who underwent implant-based skin-sparing immediate breast reconstruction with ADM in the time period March 2012 to October 2015. A total of 92 patients undergoing 128 breasts reconstructions were included in the study. An evaluation of complications before and after the implementation of LA-ICGA was performed.
No significant difference in necrosis rates requiring surgical revision (p = .411) or conservative treatment (p = .149) in patients undergoing implant-based immediate breast reconstruction were found.
Our results differ from previously published studies in that no beneficial effect on necrosis rates of was found after implementing LA-ICGA, possibly due to our limited sample size.
基于植入物的即刻乳房重建术中的坏死是一种令人担忧的并发症。术中准确评估乳房切除皮瓣对于降低此风险很有必要。本研究是斯堪的纳维亚地区首个回顾激光辅助吲哚菁绿荧光血管造影术（LA - ICGA）围手术期评估效果的研究。
采用丹麦奥胡斯大学医院整形与乳腺外科电子病历数据，对2012年3月至2015年10月期间所有接受基于植入物的保留皮肤即刻乳房重建并使用ADM的患者进行回顾性研究。本研究共纳入92例接受128次乳房重建的患者。对实施LA - ICGA前后的并发症进行了评估。
在接受基于植入物的即刻乳房重建的患者中，需要手术修复的坏死率（p = 0.411）或保守治疗的坏死率（p = 0.149）均未发现显著差异。
我们的结果与先前发表的研究不同，在实施LA - ICGA后未发现对坏死率有有益影响，可能是由于我们的样本量有限。
