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乳腺癌肿瘤整形与重建手术后患者报告结局的三维模拟:一项随机试验

Three-dimensional Simulation on Patient-reported Outcomes Following Oncoplastic and Reconstructive Surgery of the Breast: A Randomized Trial.

作者信息

Kuroda Flávia, Urban Cícero A, Dória Maíra, Rabinovich Íris, Spautz Cleverton, Lima Rubens, Schunemann Eduardo, Furlan Karina Anselmi, Nissen Leonardo, Fornazari Alessandra C, Soares Isabela, Sobreiro Bernardo, Lourenço Mateus, Loureiro Marcelo

机构信息

From the Breast Unit, Hospital Nossa Senhora das Graças, Curitiba, Brazil.

Post-graduation Program in Biotechnology, Universidade Positivo, Curitiba, Brazil.

出版信息

Plast Reconstr Surg Glob Open. 2024 May 15;12(5):e5804. doi: 10.1097/GOX.0000000000005804. eCollection 2024 May.

Abstract

BACKGROUND

Three-dimensional (3D) imaging using computer simulations is an evolving technology. There is a lack of strong data on the use of this technology for oncoplastic (OP) and reconstructive surgery.

METHODS

A prospective, randomized, single-center trial including breast cancer patients undergoing OP or mastectomy with immediate breast reconstruction with implant (IBR) enrolled from November 2019 to October 2021 at the Hospital Nossa Senhora das Graças, Breast Unit in Curitiba, Brazil. Both patients undergoing OP and those in the IBR group were randomized to undergo 3D imaging and simulation of postoperative results (intervention group) or 3D imaging without simulation (control group). All patients were invited to complete a patient-reported outcome (BREAST-Q) expectations module and breast reconstruction or reduction/mastopexy module before and 6 months after surgery.

RESULTS

A total of 96 patients were enrolled. Sixty-nine patients (45 OP and 24 IBR) completed the pre- and postoperative questionnaires and were randomized for the simulation. Women in the OP group had higher expectations for breast appearance when clothed than those in the IBR implant group (93.4 ± 16.3 versus 82.9 ± 26.5; = 0.03). The intervention group was more satisfied with information than the control group ( = 0.021). Both patients who underwent OP and IBR believed that the 3D simulation helped them understand the surgical process (86.6% and 75%, respectively).

CONCLUSIONS

Preoperative 3D simulation significantly improved patient's satisfaction with information and did not decrease postoperative satisfaction with the outcomes. The incorporation of preoperative 3D simulation may be a valuable tool in breast reconstruction.

摘要

背景

使用计算机模拟的三维(3D)成像技术是一项不断发展的技术。关于该技术在肿瘤整形(OP)和重建手术中的应用,缺乏有力的数据支持。

方法

这是一项前瞻性、随机、单中心试验,纳入了2019年11月至2021年10月在巴西库里蒂巴的圣母格拉西亚医院乳腺科接受OP或乳房切除术并立即进行植入物乳房重建(IBR)的乳腺癌患者。接受OP的患者和IBR组患者均被随机分为接受术后结果的3D成像和模拟(干预组)或不进行模拟的3D成像(对照组)。所有患者均被邀请在手术前和术后6个月完成患者报告结局(BREAST-Q)期望模块以及乳房重建或缩小/乳房上提模块。

结果

共纳入96例患者。69例患者(45例OP和24例IBR)完成了术前和术后问卷并被随机分配进行模拟。OP组女性对穿着时乳房外观的期望高于IBR植入组女性(93.4±16.3对82.9±26.5;P = 0.03)。干预组对信息的满意度高于对照组(P = 0.021)。接受OP和IBR的患者均认为3D模拟有助于他们了解手术过程(分别为86.6%和75%)。

结论

术前3D模拟显著提高了患者对信息的满意度,且未降低术后对结果的满意度。术前3D模拟的纳入可能是乳房重建中的一种有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74c8/11095956/ccfba72ef307/gox-12-e5804-g001.jpg

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