Scampa Matteo, Martineau Jérôme, Boet Sylvain, Pignel Rodrigue, Kalbermatten Daniel F, Oranges Carlo M
Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, 1205, Geneva, Switzerland.
Subaquatic and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 1205, Geneva, Switzerland.
JPRAS Open. 2024 Aug 7;42:1-9. doi: 10.1016/j.jpra.2024.07.017. eCollection 2024 Dec.
Radiotherapy is a challenge in autologous breast reconstruction because of its impact on cutaneous and vascular systems. Hyperbaric oxygen therapy (HBOT) is a recognized treatment of radiation-related complications. We aimed to assess the impact of perioperative HBOT on irradiated breast microvascular reconstructive outcomes.
We reviewed the medical charts of patients who received radiotherapy and then underwent secondary free autologous breast reconstruction at our institution. Data on demographics, HBOT protocol, intervention characteristics and post-operative complications were collected. Outcomes of the irradiated patients were then compared between the HBOT and non-HBOT groups.
Fourteen patients were included (11 unilateral and 2 bilateral deep inferior epigastric artery perforator flaps and 1 free transverse rectus abdominis muscle flap). Seven patients received HBOT and 7 did not. In the non-HBOT group, there were 1 Clavien-Dindo grade II, 1 Clavien-Dindo grade IIIa and 2 Clavien-Dindo grade IIIb post-operative complications. In the HBOT group, there were 3 Clavien-Dindo grade I, 1 Clavien-Dindo grade IIIa and 2 Clavien-Dindo grade IIIb post-operative complications. The mean operative time was 452.3 minutes (SD ±62.4 minutes) for unilateral cases without HBOT and 457.8 minutes (SD ±102.1 minutes) with HBOT (=0.913). Mean ischaemia time per flap without HBOT was 109.4 minutes (SD ±51.8 minutes) versus 80.1 minutes (SD ±37.7 minutes) in the HBOT group (=0.249).
This study provides insights into the potential of HBOT treatment in preparing patients with irradiated breast cancer for secondary autologous reconstruction.
放疗对皮肤和血管系统有影响，因此在自体乳房重建中是一项挑战。高压氧治疗（HBOT）是一种公认的治疗放疗相关并发症的方法。我们旨在评估围手术期HBOT对接受放疗的乳房微血管重建结果的影响。
我们回顾了在本机构接受放疗后进行二期自体游离乳房重建的患者的病历。收集了人口统计学数据、HBOT方案、干预特征和术后并发症的数据。然后比较HBOT组和非HBOT组中接受放疗患者的结果。
纳入了14例患者（11例单侧和2例双侧腹壁下深动脉穿支皮瓣以及1例游离腹直肌肌皮瓣）。7例患者接受了HBOT，7例未接受。在非HBOT组中，有1例Clavien-Dindo二级、1例Clavien-Dindo三级a和2例Clavien-Dindo三级b术后并发症。在HBOT组中,有3例Clavien-Dindo一级、1例Clavien-Dindo三级a和2例Clavien-Dindo三级b术后并发症。未接受HBOT的单侧病例平均手术时间为452.3分钟（标准差±62.4分钟），接受HBOT的为457.8分钟（标准差±102.1分钟）（P=0.913）。未接受HBOT时每个皮瓣的平均缺血时间为109.4分钟（标准差±51.8分钟），而在HBOT组中为80.1分钟（标准差±37.7分钟）（P=0.249）。
本研究为HBOT治疗在使接受放疗的乳腺癌患者准备进行二期自体重建方面的潜力提供了见解。
