Zeeshan Sana, Vohra Lubna Mushtaque, Shamsi Uzma Shoaib, Zahid Nida, Ali Danish, Khan Nargis, Garusi Cristina
Section of Breast Surgery, Department of Surgery, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, 74800, Pakistan.
Department of Community Health Sciences, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, 74800, Pakistan.
Ann Med Surg (Lond). 2022 Nov 17;84:104916. doi: 10.1016/j.amsu.2022.104916. eCollection 2022 Dec.
BACKGROUND & OBJECTIVES: Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fasciocutaneous pedicled chest wall perforator flaps or local perforator flaps (LPF). The objectives of this study were to document the details of the surgical procedure as well as patient-reported satisfaction and well-being following the procedure using a validated BREAST-Q tool among Pakistani women.
MATERIALS & METHODS: This cross-sectional study was conducted from March 2019 to February 2021 enrolling 25 female patients who underwent breast conservative surgery using LPF for breast tumors at The Aga Khan University Hospital, Karachi. Data related to the procedure was collected on a pre-designed proforma. Cosmetic outcomes and patient satisfaction were evaluated using 2 scales from BREAST-Q BCT domain version 2.0. The questionnaire was self-administered by the patients during their routine follow-up in the clinic. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Mean (SD)/median (IQR) were computed for quantitative variables and frequency and percentages were calculated for qualitative variables. 2 sample -test was applied. P-value ≤0.05 was considered significant.
25 patients underwent LPF with a mean age of 47 ± 13.1 years. 8 LICAP, 7 AICAP, and 10 LTAP flaps were performed. Two postoperative complications of wound site erythema were encountered. 23 women were eligible for the BREAST-Q survey. Median (IQR) postoperative satisfaction with breasts and physical well-being chest (equivalent Rasch transformed score) was 100 (41) and 76 [18] respectively. We found high satisfaction with breasts and comparable physical well-being among Pakistani women after LPF surgeries.
Local perforator flaps in oncoplastic breast-conserving surgery are a good option showing high satisfaction with breasts and physical well-being in Pakistani women.
多年来出现了各种肿瘤整形技术，以在不损害肿瘤切除原则的前提下保持乳房美观和对称。用于乳房容积置换以实现对称和美观的较新技术之一是使用带蒂筋膜皮瓣胸壁穿支皮瓣或局部穿支皮瓣（LPF）。本研究的目的是记录手术过程的详细情况，以及在巴基斯坦女性中使用经过验证的BREAST-Q工具评估患者术后报告的满意度和健康状况。
本横断面研究于2019年3月至2021年2月进行，纳入了25例在卡拉奇阿迦汗大学医院接受使用LPF进行乳腺肿瘤保乳手术的女性患者。与手术相关的数据通过预先设计的表格收集。使用BREAST-Q BCT领域版本2.0的两个量表评估美容效果和患者满意度。问卷由患者在门诊常规随访期间自行填写。使用社会科学统计软件包（SPSS）版本23进行数据分析。计算定量变量的均值（标准差）/中位数（四分位间距），计算定性变量的频率和百分比。应用双样本检验。P值≤0.05被认为具有统计学意义。
25例患者接受了LPF手术，平均年龄为47±13.1岁。共进行了8例横向内侧穿支皮瓣（LICAP）、7例前侧肋间穿支皮瓣（AICAP）和10例外侧胸背动脉穿支皮瓣（LTAP）。术后出现2例伤口部位红斑并发症。23名女性符合BREAST-Q调查条件。术后对乳房和胸部身体健康的中位数（四分位间距）满意度（等效Rasch转换评分）分别为100（41）和76[18]。我们发现巴基斯坦女性在接受LPF手术后对乳房高度满意，身体健康状况相当。
肿瘤整形保乳手术中的局部穿支皮瓣是一个很好的选择，在巴基斯坦女性中显示出对乳房和身体健康的高度满意度。
