DIEP Donor Site Satisfaction between Patients with and without History of Pregnancy.

IF 2.2 3区 医学 Q2 SURGERY Journal of reconstructive microsurgery Pub Date : 2024-09-01 Epub Date: 2024-01-04 DOI:10.1055/a-2238-8399
David Chon-Fok Cheong, Allen Wei-Jiat Wong, Shu-Wei Kao, Shu-Ying Chang, Jung-Ju Huang
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Abstract

Background:  With the success of free autologous breast reconstruction, the abdominal donor site is now an important consideration, especially in patients of childbearing age. In our institution, there are increasing patients who have successfully undergone the deep inferior epigastric artery perforator (DIEP) flap despite previous pregnancy. This study aims to answer questions on the effect of the donor site on pregnancy and vice versa.

Methods:  A retrospective cohort study was conducted to identify breast cancer patients who received a free DIEP flap for breast reconstruction from January 2018 to August 2020. Patients were allocated to two groups according to whether they had prior pregnancies with successful deliveries. Demographics, flap-related parameters, surgical outcomes on breast and abdomen, and patient-reported outcome (Breast-Q questionnaire) were analyzed. Patients were excluded if follow-up time was less than 1 year, or if there was incomplete medical records or Breast-Q replies.

Results:  Ninety-nine of 116 patients had had successful pregnancies with delivery, 17 of them remained nulliparous. No statistically significant differences existed between groups regarding demographic data, flap-related parameters, surgical outcomes on breast and abdomen. Nulliparous patients exhibited significantly lower score in physical well-being in the abdomen domain compared with delivery-experienced patients (62.1 vs. 73.4, p = 0.025). Significantly, nulliparous patients felt more tightness and pulling of the abdominal wall than the delivery-experienced patients (2.9 vs. 3.7; p = 0.05 and 3.5 vs. 4.0; p = 0.04).

Conclusion:  Free DIEP flap can be transferred safely in nulliparous patients despite a slight increase in abdominal tightness and abdominal pulling. Precise flap design and surgical approaches may help to minimize the abdominal discomfort especially on young, normal body mass index, and nonchildbearing patients.

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有妊娠史和无妊娠史患者对 DIEP 供体部位的满意度。
背景 随着游离自体乳房重建术的成功,腹部供体部位现在成为一个重要的考虑因素,尤其是对于育龄期患者。在我院,越来越多的患者在曾怀孕的情况下仍成功接受了 DIEP 皮瓣手术。本研究旨在回答供体部位对妊娠的影响以及反之亦然的问题。方法 对2018年1月至2020年8月期间接受游离下腹深动脉穿孔器(DIEP)皮瓣进行乳房重建的乳腺癌患者进行回顾性队列研究。根据患者是否曾妊娠并成功分娩,将其分为两组。对人口统计学、皮瓣相关参数、乳房和腹部手术效果以及患者报告效果(Breast-Q问卷)进行了分析。如果随访时间少于一年,或医疗记录或 Breast-Q 问卷答复不完整,则排除患者。结果 116 例患者中有 99 例成功妊娠并分娩,其中 17 例仍为无阴道妊娠。各组之间在人口统计学数据、皮瓣相关参数、乳房和腹部手术结果等方面没有明显差异。与有分娩经验的患者相比,空腹患者在腹部领域的身体健康得分明显较低(62.1 分对 73.4 分,P = 0.025)。与分娩经验丰富的患者相比,空腹患者明显感觉到更多的腹壁紧绷感和牵拉感(2.9 对 3.7;p = 0.05 和 3.5 对 4.0;p = 0.04)。精确的皮瓣设计和手术方法有助于将腹部不适感降至最低,尤其是对于年轻、体重指数正常和未生育的患者。
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来源期刊
CiteScore
4.50
自引率
28.60%
发文量
80
审稿时长
1 months
期刊介绍: The Journal of Reconstructive Microsurgery is a peer-reviewed, indexed journal that provides an international forum for the publication of articles focusing on reconstructive microsurgery and complex reconstructive surgery. The journal was originally established in 1984 for the microsurgical community to publish and share academic papers. The Journal of Reconstructive Microsurgery provides the latest in original research spanning basic laboratory, translational, and clinical investigations. Review papers cover current topics in complex reconstruction and microsurgery. In addition, special sections discuss new technologies, innovations, materials, and significant problem cases. The journal welcomes controversial topics, editorial comments, book reviews, and letters to the Editor, in order to complete the balanced spectrum of information available in the Journal of Reconstructive Microsurgery. All articles undergo stringent peer review by international experts in the specialty.
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