Predesigned Breast Shaping Assisted by Multidetector-Row Computed Tomographic Angiography in Autologous Breast Reconstruction

被引:16
作者
Dionyssiou, Dimitrios
Demiri, Efterpi
Tsimponis, Antonios
Boorman, John
机构
[1] Aristotle Univ Thessaloniki, Papageorgiou Hosp Thessaloniki, Sch Med, Dept Plast Surg, Thessaloniki, Greece
[2] Queen Victoria Hosp, Dept Plast Surg, E Grinstead, W Sussex, England
关键词
PERFORATOR FLAPS; TRAM; EXPERIENCE; TRENDS; UNIT;
D O I
10.1097/01.prs.0000436848.02033.2e
中图分类号
R61 [外科手术学];
学科分类号
100210 [外科学];
摘要
Background: Free abdominal flaps are the first option in autologous breast reconstruction using the multidetector-row computed tomographic angiography for mapping the abdominal perforators. The authors aim to evaluate the impact of using a preoperative design for shaping the new breast symmetrical to the contralateral breast, assisted by multidetector-row computed tomographic angiography. Methods: Thirty-two consecutive patients who underwent delayed unilateral breast reconstruction with free abdominal flaps were divided into two groups. In group A, the new breast was shaped intraoperatively and inset, whereas in group B, a preoperative design of the new breast was used. All patients underwent multidetector-row computed tomographic angiography before the operation and the flaps were centralized around the selected perforators. Both groups were evaluated for the time spent on flap harvest, time spent on breast shaping and inset, complication rates, and secondary operations required for breast symmetrization. Independent surgeons evaluated the final aesthetic outcome. Results: The mean time spent on harvesting the flap was not significantly different between the two groups (p > 0.05); the mean time spent on breast shaping and inset was significantly shorter in group B (p < 0.001). There were no differences between the two groups regarding complications recorded, whereas symmetrization surgery was significantly less in group B (p < 0.05). At a mean follow-up 17.3 months, the final aesthetic outcome was greater in group B. Conclusion: Predesigned breast shaping assisted by multidetector-row computed tomographic angiography promotes a significant reduction in the overall operative time and the need for secondary symmetrization procedures.
引用
收藏
页码:100E / 108E
页数:9
相关论文
共 20 条
[1]
PREOPERATIVE TRAM FLAP PLANNING FOR POSTMASTECTOMY BREAST RECONSTRUCTION [J].
BERRINO, P ;
SANTI, P .
ANNALS OF PLASTIC SURGERY, 1988, 21 (03) :264-272
[2]
Shaping the Breast in Aesthetic and Reconstructive Breast Surgery: An Easy Three-Step Principle. Part II-Breast Reconstruction after Total Mastectomy [J].
Blondeel, Phillip N. ;
Hijjawi, John ;
Depypere, Herman ;
Roche, Nathalie ;
Van Landuyt, Koenraad .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2009, 123 (03) :794-805
[3]
Doppler flowmetry in the planning of perforator flaps [J].
Blondeel, PN ;
Beyens, G ;
Verhaeghe, R ;
Van Landuyt, K ;
Tonnard, P ;
Monstrey, SJ ;
Matton, G .
BRITISH JOURNAL OF PLASTIC SURGERY, 1998, 51 (03) :202-209
[4]
Davison SP, 2006, PLAST RECONSTR SURG, V117, P1692, DOI 10.1097/01.prs.0000218333.28814.e5
[5]
TAILORING OF THE NEW BREAST USING THE TRANSVERSE ABDOMINAL ISLAND FLAP [J].
ELLIOTT, LF ;
HARTRAMPF, CR .
PLASTIC AND RECONSTRUCTIVE SURGERY, 1983, 72 (06) :887-893
[6]
Breast reconstruction with the deep inferior epigastric perforator flap: History and an update on current technique [J].
Granzow, Jay W. ;
Levine, Joshua L. ;
Chiu, Ernest S. ;
Allen, Robert J. .
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 2006, 59 (06) :571-579
[7]
SHAPING THE BREAST IN SECONDARY MICROSURGICAL BREAST RECONSTRUCTION: SINGLE- VS. TWO-ESTHETIC UNIT RECONSTRUCTION [J].
Gravvanis, Andreas ;
Smith, Roger W. .
MICROSURGERY, 2010, 30 (07) :509-516
[8]
Doppler sonography and color duplex imaging for planning a perforator flap [J].
Hallock, GG .
CLINICS IN PLASTIC SURGERY, 2003, 30 (03) :347-+
[9]
Precision transverse rectus abdominis muscle flap breast reconstruction - A reliable technique for efficient preoperative planning [J].
Kanchwala, Suhail K. ;
Bucky, Louis P. .
ANNALS OF PLASTIC SURGERY, 2008, 60 (05) :521-526
[10]
Trends in unilateral breast reconstruction and management of the contralateral breast: The Emory experience [J].
Losken, A ;
Carlson, GW ;
Bostwick, J ;
Jones, GE ;
Culbertson, JH ;
Schoemann, M .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2002, 110 (01) :89-97