Department of Breast Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Department of Breast Surgery, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Eur J Surg Oncol. 2020 Dec;46(12):2202-2207. doi: 10.1016/j.ejso.2020.07.008. Epub 2020 Jul 29.
Autologous reconstruction after mastectomy became more and more popular, so this study aimed to obtain up-to-date and comprehensive data on autologous reconstruction in China.
An electronic questionnaire was sent to 110 hospitals, which were chosen depending on geographical distribution and hospital types. The questionnaire investigated the demographics, characteristics, breast cancer treatment and reconstruction situation of these hospitals through different modules. We only focused on the autologous breast reconstruction module data.
96 hospitals have performed breast reconstruction surgery. The proportion of the hospital performing latissimus dorsi flap (LDF, N = 91), pedicle transverse rectus abdominis myocutaneous flap (pTRAM, N = 62), free abdominal flap (N = 43) and other kinds of flap decreased in sequence. Of the overall reconstruction cases, only 34.3% were autologous reconstruction and LDF was still the most popular option for autologous reconstruction. Related factors of hospital performing different procedures included years of performing breast reconstruction, breast surgical volume, and establishment of an independent plastic surgery department. Compared with LDF, abdominal breast reconstruction was associated with a higher flap necrosis rate.
This cross-sectional survey offers real-life autologous reconstruction information on a large population and covers the national surgical landscape in China. Autologous reconstruction is still an important part of breast reconstruction. Nevertheless, its low proportion and lower proportion of abdominal flap reconstruction in each institution, demonstrates that special training should be developed for breast surgeons and multidisciplinary cooperation would be promoted in the future.
乳房切除术后的自体重建越来越受欢迎，因此本研究旨在获取中国自体重建的最新和全面数据。
向 110 家医院发送了电子问卷，这些医院是根据地理位置和医院类型选择的。该问卷通过不同的模块调查了这些医院的人口统计学、特征、乳腺癌治疗和重建情况。我们只关注自体乳房重建模块的数据。
96 家医院开展了乳房重建手术。医院开展背阔肌皮瓣（LDF，N=91）、带蒂横行腹直肌肌皮瓣（pTRAM，N=62）、游离腹壁皮瓣（N=43）和其他种类皮瓣的比例依次降低。在所有重建病例中，仅有 34.3%为自体重建，LDF 仍然是自体重建最受欢迎的选择。医院开展不同手术的相关因素包括开展乳房重建的年限、乳房手术量以及独立整形外科的建立。与 LDF 相比，腹部乳房重建与更高的皮瓣坏死率相关。
这项横断面调查提供了关于大量人群的真实自体重建信息，并涵盖了中国全国的手术情况。自体重建仍然是乳房重建的重要组成部分。然而，其低比例和每个机构中腹部皮瓣重建的较低比例表明，应针对乳房外科医生开展专门培训，并在未来促进多学科合作。
