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乳房切除术后一期即刻乳房重建的患者满意度:一项关于假体、横向腹直肌肌皮瓣和腹直肌肌皮瓣技术的多中心患者对比评估。

Patient satisfaction in one-stage immediate breast reconstruction after mastectomy: A multi-center comparative patient evaluation of prosthesis, LDMF, and TRAM techniques.

作者信息

Lei Chuqi, Xu Lijie, Xu Feng, Li Jie, Jiang Hongchuan, Guan Shan, Wang Xiang, Wen Bing, Li Jinfeng, Li Xiru, Geng Cuizhi, Yin Jian

机构信息

Department of Breast Surgery.

Department of General Surgery, Beijing Chao-Yang Hospital.

出版信息

Medicine (Baltimore). 2020 May 29;99(22):e19991. doi: 10.1097/MD.0000000000019991.

Abstract

To analyze patient satisfaction and the predictive factors characterizing three types of one-stage immediate breast reconstruction (IBR) after mastectomy, including prosthesis, latissimus dorsi myocutaneous flap (LDMF), transverse rectus abdominis myocutaneous (TRAM) flap techniques.Data were collected via face-to-face or telephone interviews from eight breast centers in China from January 2012 to December 2016. A standardized questionnaire that evaluated the general satisfaction and aesthetic satisfaction was sent to patients who had undergone IBR. Logistic regression analysis was performed to identify risk factors associated with patient satisfaction among the three types of breast reconstruction.A total of 412 questionnaires were sent out, and 309 copies were collected including 226 prosthesis, 46 LDMF, and 37 pedicle TRAM reconstruction. Logistic regression analysis showed that general satisfaction and aesthetic satisfaction were significantly correlated with radiotherapy (P < .001, P = .018), respectively. Besides, the aesthetic satisfaction was also associated with nipple-areola complex (NAC) preservation (P < .001).Our multi-center study identified factors of higher patient satisfaction, like NAC preservation and absence of radiotherapy, in order to help breast surgeons make better decisions about individualized reconstruction plan.

摘要

分析乳房切除术后三种一期即刻乳房重建(IBR)类型(包括假体、背阔肌肌皮瓣(LDMF)、腹直肌肌皮瓣(TRAM)技术)患者的满意度及预测因素。2012年1月至2016年12月期间,通过面对面或电话访谈从中国八个乳腺中心收集数据。向接受IBR的患者发送一份评估总体满意度和美学满意度的标准化问卷。进行逻辑回归分析,以确定三种乳房重建类型中与患者满意度相关的危险因素。共发放问卷412份,回收309份,其中假体植入226例、背阔肌肌皮瓣46例、带蒂腹直肌肌皮瓣重建37例。逻辑回归分析显示,总体满意度和美学满意度分别与放疗显著相关(P<0.001,P=0.018)。此外,美学满意度还与乳头乳晕复合体(NAC)保留有关(P<0.001)。我们的多中心研究确定了患者满意度较高的因素,如NAC保留和未进行放疗,以帮助乳腺外科医生更好地制定个体化重建计划。

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