Chair of Plastic Surgery, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome - Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
J Plast Reconstr Aesthet Surg. 2023 Jun;81:99-104. doi: 10.1016/j.bjps.2023.02.025. Epub 2023 Feb 26.
Breast reconstruction (BR) is an essential part of breast cancer treatment, and the DIEP flap is considered the gold standard reconstruction technique, which uses a free abdominal flap. Concerns have been raised regarding the effects of abdominoplasty on respiratory functions. This topic has not been addressed regarding donor-site closure of DIEP flaps. Our aim is to prospectively compare preoperative and postoperative spirometry in patients undergoing DIEP flap-based BR, investigating its impact on respiratory function.
We enrolled 21 patients who received BR with DIEP flap in our institution, who underwent pulmonary function assessment by spirometry 1 month preoperatively and 1 year postoperatively. We assessed Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, and Peak Expiratory Flow (PEF). Statistical analysis was performed using the paired samples test.
An improvement in the mean values of all 4 variables was found at 1 year from surgery. Namely, FEV1 improved by 0.1 L with a standard deviation (SD) of 0.39 L, FVC by 0.04 L with SD of 0.627, FEV1/FVC by 2.11 L with SD of 7.85 L, and PEF by 1.2 L with SD of 1.45 L. Only PEF was statistically significant [P = 0.001].
Our results suggest that DIEP flap BR does not negatively impact respiratory function. Although further knowledge is required, we confirm the possibility of considering the indication for abdominoplasty and DIEP flap reconstruction in patients with altered and reduced pulmonary function.
乳房重建（BR）是乳腺癌治疗的重要组成部分，腹壁皮瓣游离移植（DIEP）被认为是黄金标准的重建技术，它使用游离腹部皮瓣。人们对腹部整形术对呼吸功能的影响表示担忧。然而，关于 DIEP 皮瓣供区关闭对呼吸功能的影响，这一问题尚未得到解决。我们的目的是前瞻性比较接受 DIEP 皮瓣乳房重建术（BR）的患者术前和术后的肺功能，研究其对呼吸功能的影响。
我们招募了 21 名在我院接受 DIEP 皮瓣 BR 的患者，他们在术前 1 个月和术后 1 年接受了肺功能评估，通过肺活量测定法进行检测。我们评估了第 1 秒用力呼气量（FEV1）、用力肺活量（FVC）、FEV1/FVC 比值和呼气峰流量（PEF）。使用配对样本检验进行统计分析。
术后 1 年，所有 4 项指标的平均值均有所改善。具体而言，FEV1 增加了 0.1 L，标准差（SD）为 0.39 L，FVC 增加了 0.04 L，SD 为 0.627，FEV1/FVC 增加了 2.11 L，SD 为 7.85 L，PEF 增加了 1.2 L，SD 为 1.45 L。只有 PEF 具有统计学意义（P=0.001）。
我们的结果表明，DIEP 皮瓣 BR 不会对呼吸功能产生负面影响。尽管需要进一步的知识，但我们证实了在肺功能改变和降低的患者中，考虑腹部整形术和 DIEP 皮瓣重建的适应证的可能性。
