Groen Jan-Willem, Piatkowski Andrzej A, Sawor John H, Wilschut Janneke A, Ritt Marco J P F, van der Hulst Rene R J W
Department of Plastic, Reconstructive and Hand Surgery/ GROW: School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, VU Medical Center, Amsterdam, Netherlands.
Surg Innov. 2018 Dec;25(6):602-615. doi: 10.1177/1553350618799553. Epub 2018 Sep 24.
. The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. . The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. . An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries. The differences between countries and levels of experience were analyzed using a logistic regression model. . The mean respondent age, out of the 358 completed questionnaires, was 46 years. Ninety-seven percent of the respondents were plastic surgeons, who practiced AFT mostly in breast surgery and considered themselves experienced with the technique. The thigh and abdomen were less favored harvest locations by the Belgium and French respondents, respectively, and both the French and Austrian respondents preferred manual aspiration over liposuction in harvesting the fat. Despite minor differences between countries and experience, the intraglandular space was injected in all subgroups. . The expanding use of AFT in Europe will lead to more experience and heterogeneity regarding the technique. However, despite an obvious adherence to Coleman's method, deviations thereof become more apparent. An important example of such a deviation is the ongoing practice of intraglandular AFT despite being a contraindication in various European guidelines. These unsafe practices should be avoided until scientific clarification regarding oncological safety is obtained and should therefore be the focus of surgeon education in Europe.
本研究旨在考察欧洲外科医生进行自体脂肪移植（AFT）的经验，并突出不同国家以及不同经验水平之间的差异。AFT的普及促使复杂的科学研究和临床应用不断增加。虽然前者的结果有充分记录，但后者的重要方面却远未得到充分认识。一项关于外科医生背景（除了AFT的熟悉程度、技术和观点）的国际调查研究在来自10个欧洲国家的外科医生中展开。使用逻辑回归模型分析了国家和经验水平之间的差异。在358份完成的问卷中，受访者的平均年龄为46岁。97%的受访者是整形外科医生，他们大多在乳房手术中进行AFT，并认为自己对该技术有经验。比利时和法国的受访者分别不太倾向于选择大腿和腹部作为脂肪采集部位，法国和奥地利的受访者在采集脂肪时都更倾向于手动抽吸而非抽脂。尽管不同国家和经验之间存在细微差异，但所有亚组均进行了腺体内注射。AFT在欧洲的广泛应用将带来更多关于该技术的经验和异质性。然而，尽管明显遵循科尔曼方法，但其中的偏差变得更加明显。这种偏差的一个重要例子是尽管在欧洲各种指南中腺体内AFT是禁忌，但仍在持续进行。在获得关于肿瘤安全性的科学澄清之前，应避免这些不安全做法，因此这应成为欧洲外科医生教育的重点。
