Chest wall perforator flap reconstruction in breast conserving surgery: quality of life and limited complications in outpatient treatment.

IF 2.5 3区医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2025-01-23 DOI:10.1186/s12957-024-03638-5

L J van Zeelst, R Straten, R R J P van Eekeren, D J P van Uden, J H W de Wilt, L J A Strobbe

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Abstract

Background: Breast conserving surgery (BCS) with partial breast reconstruction (PBR) results in less morbidity, better cosmetic outcomes, and improved patient satisfaction compared to mastectomy. Perforator flap reconstruction can attenuate defects prone to breast deformity after BCS. Usually, postoperative drains and inpatient admission are part of this treatment. The main objective of this study is to report on postoperative complications and patient satisfaction after drainless perforator flap reconstruction by a dedicated breast surgeon.

Methods: In a retrospective case series, 42 patients were included. All patients underwent BCS with drainless perforator flap reconstruction, planned and performed by a single breast surgeon. Outcomes were complication incidence and patient satisfaction reported in the Breast-Q Breast Conserving Therapy (BCT) module.

Results: In the study cohort, the median age was 59.5 (49.8-71.3) years. Tumour types were ductal carcinoma in situ (DCIS, four patients, 9.5%), invasive no special type (NST, 22 patients, 52.4%), invasive lobular (12 patients, 28.6%), and other invasive cancers (4 patients, 9.5%). Complication incidence was seven of 42 patients (16.7%), including hematoma, seroma, wound dehiscence, fat necrosis, and lymphedema, all Clavien Dindo grade 0-1, without readmission or reoperation. Reported Breast-Q scores (median of 17 months after surgery) were 87/100 for psychosocial well-being, 82/100 for breast satisfaction, and 71/100 for physical well-being. Outpatient treatment was successful in 38 patients (90.5%), and 13 patients (31.0%) had an unplanned visit to the outpatient clinic.

Conclusion: Drainless perforator flap reconstruction performed by the breast surgeon results in high patient satisfaction and limited complications, both in number and severity. The use of drains and hospital stays after perforator flap reconstruction must be discouraged.

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保乳手术中胸壁穿支皮瓣重建：门诊治疗的生活质量和并发症。

背景：与乳房切除术相比，保乳手术（BCS）与部分乳房重建（PBR）的发病率更低，美容效果更好，患者满意度更高。穿支皮瓣重建可减轻BCS术后乳腺畸形的发生率。通常，术后引流和住院是该治疗的一部分。本研究的主要目的是报告由专门的乳房外科医生进行无引流穿支皮瓣重建的术后并发症和患者满意度。方法：回顾性分析42例患者。所有患者均接受无引流穿支皮瓣重建的BCS，由一名乳房外科医生计划和执行。结果是在Breast- q保乳治疗（BCT）模块中报告的并发症发生率和患者满意度。结果：在研究队列中，中位年龄为59.5（49.8-71.3）岁。肿瘤类型为导管原位癌（DCIS， 4例，9.5%）、浸润性无特殊类型癌（NST， 22例，52.4%）、浸润性小叶癌（12例，28.6%）和其他浸润性癌（4例，9.5%）。42例患者中并发症发生率为7例（16.7%），包括血肿、血肿、创面裂开、脂肪坏死、淋巴水肿，均为Clavien Dindo 0-1级，无再入院或再手术。报告的breast - q评分（手术后17个月的中位数）心理健康为87/100，乳房满意度为82/100，身体健康为71/100。38例（90.5%）患者门诊治疗成功，13例（31.0%）患者有计划外门诊就诊。结论：乳房外科医生行无引流穿支瓣重建术，患者满意度高，并发症少，严重程度低。穿支皮瓣重建后不建议使用引流管和住院治疗。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.