Computer-assisted autologous fat grafting for breast reconstruction of soft tissue defects in pediatric Poland syndrome
10.3760/cma.j.cn114453-20220207-00030
- VernacularTitle:计算机辅助游离脂肪移植治疗儿童Poland综合征胸部软组织畸形的效果
- Author:
Hao ZHANG
1
;
Weimin SHEN
;
Jie CUI
;
Jijun ZOU
;
Jiageng XIONG
Author Information
1. 南京医科大学附属儿童医院烧伤整形外科，南京 210008
- Keywords:
Poland syndrome;
Congenital abnormalities;
Computer-assisted;
Autografts;
Thoracoplasty
- From:
Chinese Journal of Plastic Surgery
2022;38(12):1384-1389
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the treatment of autologous fat grafting (AFG) for breast reconstruction of soft tissue defects in pediatric Poland syndrome (PS) with computer-assisted calculation.Methods:Patients with PS were recruited in Children’s Hospital of Nanjing Medical University from January 2016 to January 2021. The children were divided into two groups: CT-assisted group and control group. CT-assisted group were examined by CT scan before operation. The imaging data were imported to 3D Slicer Software. Three -dimensional (3D) reconstruction of thoracis soft tissue in defected side were created in the software with the healthy side served as controls. The obtained 3D image was divided into six sections and the volume of each section was calculated. The interest 3D model was fabricated by using a 3D resin printer. The autologous fat grafting was made in PS patients under the 3D printing model guidance. Patients in control group for AFG that the volume of fat determined by surgeon experience without CT scan. The following outcomes were studied: postoperative breast contour, local complications and major systemic complications. Patients were reviewed at six months postoperatively. The satisfaction scores were made by physicians and patient’s guardians, respectively. The scores were analyzed by the independent samples t-test. P< 0.05 was considered statistically significant. Results:18 patients is in CT-assisted group, 8 males, 12 females, the age range from 3-12 years, mean age: 8.3 years. 10 cases underwent once injection, 6 cases underwent twice injections and 3 times in 2 cases, the average is 1.5 times. 18 patients are in control group, 4 males, 14 females, the age range from 4-14 years, mean age: 8.1 years. 8 cases underwent once injection, twice in 5 cases, and 3 times in 5 cases, the average is 1.8 times. The follow-up ranged from 1 to 2 years. The chests were essentially symmetrical and upper limb and thoracic functions were unaffected, no serious local and systematic complications were observed in the CT-assisted group. Thoracic deformities were improved to various degrees in control group. There was chest induration in two cases at 6-month follow-up, which disappeared at 1-year follow-up without any treatment. The physician satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 8 and 6 cases, general 3, respectively. The patient’s satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 10 and 6cases, general 1 , respectively. The physician satisfaction scores in the CT-assisted group and control group were 83.56±7.90, 75.67±13.63, respectively, which showing statistically significant differences ( t=2.13, P=0.041). Furthermore, the patient’s guardian satisfaction scores in the CT-assisted group and control group are 84.39±7.77, 78.28±9.82, respectively, which showing statistically significant differences ( t=2.07, P=0.046). Conclusions:AFG under computer guidance is an individualized surgical method based on children’s own characteristics in improving chest deformity of PS patients, following with high postoperative satisfaction.
