Abdominal function and patient-reported satisfaction after two kinds of abdominal flap breast reconstruction
10.3760/cma.j.cn114453-20201022-00540
- VernacularTitle:两种腹部皮瓣乳房再造术后腹部功能和满意度评价
- Author:
Zhipeng LI
1
;
Lingyun XIONG
;
Rongrong WANG
;
Jie YANG
;
Jing TONG
;
Wei XIONG
;
Jiaming SUN
Author Information
1. 华中科技大学同济医学院附属协和医院整形外科，武汉 430022
- Keywords:
Mammaplasty;
Abdominal wall;
Perforator flap;
Myocutaneous flap;
Quality of life;
Patient satisfaction
- From:
Chinese Journal of Plastic Surgery
2021;37(7):745-751
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the abdominal function and aesthetics outcomes of patients with abdominally based breast reconstruction.Methods:In this research, we retrospectively analyzed the cases of breast reconstruction in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from July 2013 to June 2018. In accordance with the inclusion and exclusion criteria, patients undergoing breast reconstruction by deep inferior epigastric perforator flap (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous flap (TRAM) were included in the study. A questionnaire was designed to evaluate the patient’s abdominal strength, and the BREAST-Q breast reconstruction abdominal health module was used to assess the patient’s satisfaction degree with the abdomen. SPSS 21.0 statistical software was used to analyze the data. The independent-samples t test is used for comparison between the two groups; the matched-samples t test is used for the preoperative and postoperative comparison of a single group. P<0.05 indicates that the difference is statistically significant. Results:A total of 32 patients were enrolled, including 17 cases of DIEP breast reconstruction, aged 43.6±9.2 years old, and 15 cases of TRAM breast reconstruction, aged 41.0±10.1 years old. The postoperative follow-up period ranged from 12 to 73 months, with an average of 41.5 months. Preoperative abdominal wall strength scores in the DIEP group and the TRAM group were 4.71±0.47 and 4.60±0.50 , respectively, and there were on significant difference between two groups. Three months after operation, the abdominal wall strength of the DIEP group scored 2.65±0.86, which was higher than the score in the TRAM group(1.93±0.70) ( P<0.05). The scores of the two groups were significantly different from those before operation ( P<0.01). One year after the operation, the abdominal wall strength of DIEP group scored 4.65±0.49, which was significantly higher than the score in TRAM group (4.07±0.88)( P<0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). One year after operation, the appearance of the abdomen was not significantly different between the preoperative and postoperative score in both two groups ( P>0.05). Preoperative abdominal satisfaction scores of the DIEP group and the TRAM group were 86.53±5.68 and 85.87±7.31, respectively, and there was no significant difference between two groups ( P>0.05). Three months after the operation, the abdominal satisfaction score of the DIEP group was 76.41±7.74, which was higher than the score in the TRAM group(68.00±9.08) ( P<0.01). The scores of the two groups were compared with those before surgery, and the differences were statistically significant ( P<0.01). One year after the operation, the abdominal satisfaction score was 85.00±5.32 in the DIEP group and 82.93±6.12 in the TRAM group, showing no statistical significance between two groups ( P>0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). Conclusions:The study demonstrates that both two kinds of abdominal flaps can obtain a better abdominal appearance. The long-term abdominal function and abdominal satisfaction of patients undergoing breast reconstruction with DIEP flaps can return to the baseline levels, however, that of TRAM flaps can not return to the baseline levels. Further research is needed for the longer term results.
