Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München.
Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg.
Handchir Mikrochir Plast Chir. 2021 Aug;53(4):340-348. doi: 10.1055/a-1424-1428. Epub 2021 Mar 30.
The European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) previously identified the need for harmonisation of breast reconstruction standards in Europe, in order to strengthen the role of plastic surgeons. This study aims to survey the status, current trends and potential regional differences in the practice of breast reconstruction in Europe, with emphasis on equity and access.
A largescale web-based questionnaire was sent to consultant plastic and reconstructive surgeons, who are experienced in breast reconstruction and with understanding of the national situation in their country. Suitable participants were identified via the Executive Committee (ExCo) of ESPRAS and national delegates of ESPRAS. The results were evaluated and related to evidence-based literature.
A total of 33 participants from 29 European countries participated in this study. Overall, the incidence of breast reconstruction was reported to be relatively low across Europe, comparable to other large geographic regions, such as North America. Equity of provision and access to breast reconstruction was distributed evenly within Europe, with geographic regions potentially affecting the type of reconstruction offered. Standard practices with regard to radiotherapy differed between countries and a clear demand for European guidelines on breast reconstruction was reported.
This study identified distinct lack of consistency in international practice patterns across European countries and a strong demand for consistent European guidance. Large-scale and multi-centre European clinical trials are required to further elucidate the presented areas of interest and to define European standard operating procedures.
欧洲整形、重建与美容外科学会（ESPRAS）的欧洲领导力论坛（ELF）此前确定了在欧洲统一乳房重建标准的必要性，以加强整形医生的作用。本研究旨在调查欧洲乳房重建实践的现状、当前趋势和潜在的区域差异，重点关注公平性和可及性。
通过 ESPRAS 执行委员会（ExCo）和 ESPRAS 的国家代表，向有乳房重建经验并了解本国情况的顾问级整形和重建外科医生发送了一份大规模的在线问卷。合适的参与者通过 ESPRAS 识别。评估结果并与基于证据的文献相关联。
共有来自 29 个欧洲国家的 33 名参与者参加了这项研究。总体而言，欧洲的乳房重建发生率相对较低，与北美等其他大地理区域相当。乳房重建的提供公平性和可及性在欧洲内部分布均匀，地理区域可能会影响提供的重建类型。各国之间的放疗标准实践存在差异，并报告了对乳房重建欧洲指南的明确需求。
本研究发现，欧洲各国之间的国际实践模式存在明显的不一致，强烈需要一致的欧洲指导。需要进行大规模的多中心欧洲临床试验，以进一步阐明所提出的关注领域，并确定欧洲标准操作程序。
