[Autologous Breast Reconstruction and Radiotherapy: Consensus Report of the German-Speaking Society for Reconstructive Microsurgery (GSRM)].

IF 0.4 4区 医学 Q4 SURGERY Handchirurgie Mikrochirurgie Plastische Chirurgie Pub Date : 2024-10-02 DOI:10.1055/a-2407-9254
Albrecht Heine-Geldern, Christoph Hirche, Thomas Kremer, Kristina Lössl, Alexander D Bach, Elisabeth Russe, Hisham Fansa, Justus P Beier, Yves Harder, Arash Momeni
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Abstract

Autologous postmastectomy breast reconstruction is associated with favourable long-term clinical outcomes and superior patient-reported outcomes (PROMs) compared with implant-based reconstruction. However, adjuvant radiotherapy has traditionally been considered a relative contraindication to immediate flap-based reconstruction due to its unpredictable effects on the reconstructive outcome. While modern adjuvant postmastectomy radiotherapy (PMRT) has been able to significantly reduce acute and chronic radiation-induced complications, plastic surgeons still hesitate to offer immediate autologous reconstruction to patients expected to undergo adjuvant radiotherapy. More recently, evidence has emerged suggesting a paradigm shift in favour of immediate autologous reconstruction despite subsequent radiotherapy. At the 44th Annual Meeting of the German-speaking Society for Reconstructive Microsurgery (GSRM) in Bern, Switzerland, a workshop discussed the literature on PMRT and autologous breast reconstruction, aiming to establish consensus among the participants. Several areas of agreement were identified, including the goals of postmastectomy reconstruction, specifically the creation of a soft and sensitive breast symmetrical in shape and size to the unaffected breast via the safest procedure possible. The importance of preserving the maximum amount of native breast skin envelope through skin- and nipple-sparing approaches was emphasised. Finally, a consensus was reached that PMRT should no longer be considered a contraindication to immediate autologous breast reconstruction.

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[自体乳房重建与放射治疗:自体乳房再造与放射治疗:德语国家显微再造外科协会(GSRM)共识报告]。
与假体重建相比,乳房切除术后自体乳房重建具有良好的长期临床效果和患者报告结果(PROMs)。然而,由于辅助放疗对重建结果的影响难以预测,传统上一直被认为是即刻皮瓣重建的相对禁忌症。虽然现代的辅助性乳房切除术后放疗(PMRT)已能显著减少急性和慢性放射引起的并发症,但整形外科医生在为预计接受辅助性放疗的患者提供即刻自体重建时仍然犹豫不决。最近,有证据表明,尽管随后接受了放疗,但支持立即进行自体重建的模式发生了转变。在瑞士伯尔尼举行的第44届德语显微整形外科学会(GSRM)年会上,一个研讨会讨论了有关PMRT和自体乳房重建的文献,旨在让与会者达成共识。与会者在多个领域达成了共识,其中包括乳房切除术后重建的目标,特别是通过最安全的手术方法创造一个柔软、敏感的乳房,在形状和大小上与未受影响的乳房对称。会议强调了通过保留皮肤和乳头的方法最大限度地保留原生乳房皮肤包膜的重要性。最后,与会人员达成共识:PMRT 不再被视为即刻自体乳房重建的禁忌症。
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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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