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保乳治疗中 LICAP 翻转皮瓣后应用 Breast Q 评估患者报告结局的前后评估。

A before and after evaluation of patient reported outcomes assessed by Breast Q following LICAP turnover flap in breast conservative therapy.

机构信息

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.

出版信息

Updates Surg. 2024 Jun;76(3):1047-1054. doi: 10.1007/s13304-023-01714-1. Epub 2023 Dec 9.

DOI:10.1007/s13304-023-01714-1
PMID:38071239
Abstract

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.

摘要

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。

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本文引用的文献

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Oncoplastic level II volume displacement surgery for breast cancer: oncological and aesthetic outcomes.乳腺癌整形水平 II 容积移位手术:肿瘤学和美学结果。
Updates Surg. 2023 Aug;75(5):1289-1296. doi: 10.1007/s13304-023-01472-0. Epub 2023 Mar 2.
2
Mastectomy with one-stage or two-stage reconstruction in breast cancer: analysis of early outcomes and patient's satisfaction.乳腺癌一期或二期乳房重建术:早期结果和患者满意度分析。
Updates Surg. 2023 Jan;75(1):235-243. doi: 10.1007/s13304-022-01416-0. Epub 2022 Nov 19.
3
Lateral intercostal artery perforator (LICAP) flap for breast volume augmentation: Applications for oncoplastic and massive weight loss surgery.
肋间外侧动脉穿支(LICAP)皮瓣用于乳房容积增大:在肿瘤整形和大规模减重手术中的应用
JPRAS Open. 2021 May 21;29:123-134. doi: 10.1016/j.jpra.2021.05.005. eCollection 2021 Sep.
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Survival After Breast Conservation vs Mastectomy Adjusted for Comorbidity and Socioeconomic Status: A Swedish National 6-Year Follow-up of 48 986 Women.保乳与乳房切除术治疗后的生存比较:调整合并症和社会经济地位因素后,瑞典全国 6 年随访 48986 例女性。
JAMA Surg. 2021 Jul 1;156(7):628-637. doi: 10.1001/jamasurg.2021.1438.
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Systematic review of partial breast reconstruction with pedicled perforator artery flaps: Clinical, oncological and cosmetic outcomes.带蒂穿支动脉皮瓣乳房部分重建术的系统评价:临床、肿瘤学和美容学结果。
Eur J Surg Oncol. 2021 Aug;47(8):1883-1890. doi: 10.1016/j.ejso.2021.03.249. Epub 2021 Apr 13.
6
Pedicled local flaps: a reliable reconstructive tool for partial breast defects.带蒂局部皮瓣:用于部分乳房缺损的可靠重建工具。
Gland Surg. 2019 Oct;8(5):527-536. doi: 10.21037/gs.2019.09.06.
7
The Modified Lateral Intercostal Artery Perforator Flap.改良肋间外侧动脉穿支皮瓣
Plast Reconstr Surg Glob Open. 2019 Feb 5;7(2):e2066. doi: 10.1097/GOX.0000000000002066. eCollection 2019 Feb.
8
Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study.保乳手术后两种应用肋间外侧动脉穿支皮瓣的外科技术的效用:单中心回顾性研究。
Plast Reconstr Surg. 2019 Mar;143(3):477e-487e. doi: 10.1097/PRS.0000000000005374.
9
The need to diminish mastectomy rates in patients with breast cancer eligible for breast conservation.降低适合保乳治疗的乳腺癌患者乳房切除术发生率的必要性。
Updates Surg. 2019 Sep;71(3):597-598. doi: 10.1007/s13304-018-00619-8. Epub 2019 Jan 2.
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Cancer. 2018 Apr 1;124(7):1335-1341. doi: 10.1002/cncr.31221. Epub 2018 Jan 16.