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一项前瞻性研究评估了接受胸壁穿支皮瓣的患者的患者报告结局测量。

A prospective study evaluating patient reported outcome measures in patients who have undergone chest wall perforator flaps.

机构信息

Sandwell and West Birmingham NHS Trust, City Hospital, Dudley Road, Birmingham B18 7QH, UK; Department of General Surgery, PGIMER, Chandigarh, India.

Sandwell and West Birmingham NHS Trust, City Hospital, Dudley Road, Birmingham B18 7QH, UK.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Apr;91:79-82. doi: 10.1016/j.bjps.2024.02.044. Epub 2024 Feb 9.

Abstract

AIMS

To evaluate Patient Reported Outcome Measures (PROMs) and surgical outcomes in patients undergoing Chest Wall Perforator Flaps (CWPFs).

METHODS

This was an observational single cohort study using an audit approach and a survey instrument. 84 patients who had undergone CWPFs in the last 5 years at the Department of Breast Surgery, City Hospital Birmingham, were identified from a pre-existing database. Surgical outcomes were recorded. Patients were contacted telephonically or in person at the time of follow-up and were asked to fill up a PROMs questionnaire.

RESULTS

Out of 84 patients, 58 patients chose to respond. The average age of the patients was 51.3 years (±8.2 years). The average follow-up was 15.4 months (±9.9 months). The most common histological subtype was Infiltrating ductal carcinoma (IDC)-Not otherwise specified 34/58 (58.6%). Majority of the patients had T2 cancers-28/58 (48.3%). 26/58 (44.8%) were node negative. Eight patients (13.7%) had post-operative complications. No patient had total/partial flap loss. Nine patients (15.5%) had margin re-excision. One patient developed distant metastasis while 1 patient developed a second primary. Fifty-one patients (88%) were either satisfied or very satisfied with the post-operative appearance of the breasts. Thirty-six patients (62%) had no/little persistent pain or tenderness post-surgery. Eighty-six per cent (38/44) of the patients undergoing Lateral Intercostal Artery Perforator (LICAP) Flap and 16/18 (89%) of patients undergoing Anterior Intercostal Artery Perforator (AICAP) flap had no/little difficulty in carrying out normal activities at follow up.

CONCLUSION

CWPFs are associated with a low complication rate and a high patient satisfaction rate.

摘要

目的

评估接受胸壁穿支皮瓣(CWPF)的患者的患者报告结局测量(PROM)和手术结果。

方法

这是一项观察性单队列研究,采用审计方法和调查工具。从伯明翰市立医院乳腺外科过去 5 年内接受 CWPF 的 84 名患者中,从一个预先存在的数据库中确定。记录手术结果。在随访时,通过电话或亲自联系患者,并要求他们填写 PROM 问卷。

结果

84 名患者中有 58 名选择回复。患者的平均年龄为 51.3 岁(±8.2 岁)。平均随访时间为 15.4 个月(±9.9 个月)。最常见的组织学亚型是浸润性导管癌(IDC)-非特指 34/58(58.6%)。大多数患者患有 T2 期癌症-28/58(48.3%)。26/58(44.8%)为淋巴结阴性。8 名患者(13.7%)术后发生并发症。无患者发生全部/部分皮瓣坏死。9 名患者(15.5%)行边缘再次切除术。1 名患者发生远处转移,1 名患者发生第二原发肿瘤。51 名患者(88%)对乳房的术后外观感到满意或非常满意。36 名患者(62%)术后无/轻度持续性疼痛或压痛。接受侧肋间动脉穿支皮瓣(LICAP)的 44 名患者中有 86%(38/44)和接受前肋间动脉穿支皮瓣(AICAP)的 18 名患者中有 16/18(89%)在随访时进行正常活动无/轻度困难。

结论

CWPF 并发症发生率低,患者满意度高。

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