Heidekrueger Paul I, Moellhoff Nicholas, Horch Raymund E, Lohmeyer Jörn A, Marx Mario, Heitmann Christoph, Fansa Hisham, Geenen Matthias, Gabka Christian J, Handstein Steffen, Prantl Lukas, von Fritschen Uwe
Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, 93053 Regensburg, Germany.
Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, 80336 Munich, Germany.
J Clin Med. 2021 Mar 2;10(5):1016. doi: 10.3390/jcm10051016.
While autologous breast reconstruction has gained momentum over recent years, there is limited data on the structure and quality of care of microsurgical breast reconstruction in Germany. Using the breast reconstruction database established by the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC), the presented study investigated the overall outcomes of deep inferior epigastric perforator (DIEP) flap reconstructions in Germany. Data of 3926 patients and 4577 DIEP flaps performed by 22 centers were included in this study. Demographics, patient characteristics, perioperative details and postoperative outcomes were accounted for. Centers performing < Ø 40 (low-volume (LV)) vs. ≥ Ø 40 (high-volume (HV)) annual DIEP flaps were analyzed separately. Overall, total and partial flap loss rates were as low as 2.0% and 1.1% respectively, and emergent vascular revision surgery was performed in 4.3% of cases. Revision surgery due to wound complications was conducted in 8.3% of all cases. Mean operative time and length of hospital stay was significantly shorter in the HV group (LV: 385.82 min vs. HV: 287.14 min; LV: 9.04 (18.87) days vs. HV: 8.21 (5.04) days; both < 0.05). The outcome and complication rates deduced from the national registry underline the high standard of microsurgical breast reconstruction on a national level in Germany.
近年来，自体乳房重建发展迅速，但德国关于显微外科乳房重建的护理结构和质量的数据有限。本研究利用德国整形、重建与美容外科学会（DGPRÄC）建立的乳房重建数据库，调查了德国腹壁下深动脉穿支（DIEP）皮瓣重建的总体结果。本研究纳入了22个中心实施的3926例患者和4577例DIEP皮瓣的数据。记录了人口统计学、患者特征、围手术期细节和术后结果。分别分析了每年实施DIEP皮瓣手术数量< Ø 40（低容量（LV））与≥ Ø 40（高容量（HV））的中心。总体而言，皮瓣全部和部分丢失率分别低至2.0%和1.1%，4.3%的病例进行了急诊血管修复手术。8.3%的病例因伤口并发症进行了修复手术。HV组的平均手术时间和住院时间明显更短（LV：385.82分钟 vs. HV：287.14分钟；LV：9.04（18.87）天 vs. HV：8.21（5.04）天；均< 0.05）。从国家登记处得出的结果和并发症发生率突显了德国全国范围内显微外科乳房重建的高标准。
