Burn & Plastic, Reconstructive and Aesthetic Surgery, Azienda Ospedaliera Cannizzaro, Via Messina, 829, Catania, Italy.
Plastic, Reconstructive and Aesthetic Surgery, Università Unikore Di Enna, Piazza Dell'Università, 94100, Enna, EN, Italy.
Updates Surg. 2024 Jun;76(3):1047-1054. doi: 10.1007/s13304-023-01714-1. Epub 2023 Dec 9.
Chest-wall perforator-based techniques to replace volume for breast conservative therapy allow excision of large breast areas with minimal sequalae, such as the nipple-areolar complex displacement, parenchymal indentation or contour deformity. Furthermore, chest wall perforator flaps facilitate the maintenance of breast symmetry, hence decreasing the need for contralateral surgery. Lateral intercostal flap was described in numerous variants among which the most famous are the propeller flap and the turnover version. The turnover version is the easiest and fastest version that allows the replacement of large amount of volume. In this paper, we evaluate patients reported outcomes, before and after surgery, collected through the Breast Q. This study was conducted on 21 patients who were admitted to the plastic surgery department. A prospectively maintained database was used to identify the patients and their records were assessed retrospectively. The pre/post operative patients data were collected. The Breast-Q questionnaire was administered before the surgery and at least 1 year after. No major surgical complications were reported. Mean Breast-Q scores were evaluated at least 1 year after surgery and radiotherapy and compared with pre-surgical scores. Among all the modules, no significant differences between the pre-surgical and post-surgical Breast-Q scores were observed. Until now, the lateral intercostal artery perforator flap has not been widely used, due to a difficult dissection and a challenging preoperative planning. According to the reported surgical technique, the execution is easy. This technique provides the same breast-related quality of life compared to preoperative values, reduces the mastectomy rate and increases the overall survival.
基于胸壁穿支的技术可替代乳房保留治疗的体积,使大的乳房区域切除后仅有最小的后遗症,如乳头乳晕复合体移位、实质凹陷或轮廓畸形。此外,胸壁穿支皮瓣有利于保持乳房对称性,从而减少对侧手术的需求。肋间外侧皮瓣有许多不同的变体,其中最著名的是推进瓣和翻转瓣。翻转瓣是最简单和最快的版本,可以替代大量的体积。本文通过乳房 Q 评估了患者手术前后的报告结果。该研究纳入了 21 名接受整形手术的患者。前瞻性维护的数据库用于识别患者,对其记录进行回顾性评估。收集了患者术前和术后的资料。在手术前和至少 1 年后进行了乳房 Q 问卷评估。没有报告重大手术并发症。至少在术后和放疗后 1 年评估了平均乳房 Q 评分,并与术前评分进行比较。在所有模块中,术前和术后乳房 Q 评分之间没有显著差异。迄今为止,由于解剖困难和术前规划具有挑战性,肋间外侧动脉穿支皮瓣尚未广泛应用。根据报道的手术技术,操作简单。该技术与术前值相比提供了相同的乳房相关生活质量,降低了乳房切除术的比率,并提高了总体生存率。