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双培训乳腺外科医生的 MS-TRAM/DIEP 乳房重建学习曲线。

The learning curve of the MS-TRAM/DIEP breast reconstruction by dual-trained breast surgeons.

机构信息

Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.

Breast Tumor Center, Sun Yat-sen Breast Tumor Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.

出版信息

BMC Surg. 2024 Feb 14;24(1):53. doi: 10.1186/s12893-024-02344-z.

Abstract

BACKGROUND

Breast cancer surgeries involving MS-TRAM/DIEP breast reconstruction has traditionally been collaborative efforts between breast surgeons and plastic surgeons. However, in our institution, this procedure is performed by dual-trained breast surgeons who are proficient in both breast surgery and MS-TRAM/DIEP breast reconstruction. This study aims to provide insights into the learning curve associated with this surgical approach.

MATERIALS AND METHODS

We included eligible breast cancer patients who underwent MS-TRAM/DIEP breast reconstruction by dual-trained breast surgeons between 2015 and 2020 at our institution. We present the learning curve of this surgical approach, with a focus on determining factors affecting flap harvesting time, surgery time, and ischemic time. Additionally, we assessed the surgical complication rates.

RESULTS

A total of 147 eligible patients were enrolled in this study. Notably, after 30 cases, a statistically significant reduction of 1.7 h in surgery time and 21 min in ischemic time was achieved, signifying the attainment of a plateau in the learning curve. And the major and minor complications were comparable between the early and after 30 cases.

CONCLUSION

This study explores the learning curve and feasibility experienced by dual-trained breast surgeons in performing MS-TRAM/DIEP breast reconstruction.

TRIAL REGISTRATION

NCT05560633.

摘要

背景

涉及 MS-TRAM/DIEP 乳房重建的乳腺癌手术传统上是乳腺外科医生和整形外科医生的合作努力。然而,在我们的机构中,该程序由精通乳腺手术和 MS-TRAM/DIEP 乳房重建的双训练乳腺外科医生进行。本研究旨在深入了解与这种手术方法相关的学习曲线。

材料和方法

我们纳入了 2015 年至 2020 年间在我们机构接受双训练乳腺外科医生 MS-TRAM/DIEP 乳房重建的合格乳腺癌患者。我们介绍了这种手术方法的学习曲线,重点是确定影响皮瓣采集时间、手术时间和缺血时间的因素。此外,我们评估了手术并发症发生率。

结果

共有 147 名符合条件的患者纳入本研究。值得注意的是,在进行了 30 例手术后,手术时间显著缩短了 1.7 小时,缺血时间缩短了 21 分钟,表明学习曲线达到了平台期。早期和 30 例后的主要和次要并发症相当。

结论

本研究探讨了双训练乳腺外科医生在进行 MS-TRAM/DIEP 乳房重建时所经历的学习曲线和可行性。

试验注册

NCT05560633。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7691/10865591/304d1cec186a/12893_2024_2344_Fig1_HTML.jpg

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