Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps
| Autor: | Aaron D. C. Knox, Nancy Van Laeken, Sheina A. Macadam, A. Yashar Tashakkor, Adelyn L. Ho, Peter A. Lennox, Leslie Leung |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Mammaplasty Breast surgery medicine.medical_treatment Rectus Abdominis Breast Neoplasms 030230 surgery Transplantation Autologous Abdominal wall 03 medical and health sciences 0302 clinical medicine DIEP flap Humans Medicine Hernia Retrospective Studies business.industry medicine.disease Epigastric Arteries eye diseases Surgery Transplantation medicine.anatomical_structure 030220 oncology & carcinogenesis Abdomen Female business Breast reconstruction Perforator Flap Follow-Up Studies |
| Zdroj: | Plastic and Reconstructive Surgery. 138:16-28 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000001747 |
| Popis: | There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery related to abdominal morbidity, operative time, and complications.This is a retrospective review of patients undergoing breast reconstruction using the DIEP or pTRAM flap at the University of British Columbia between 2002 and 2013. The authors compared operative time and abdomen- and flap-related complications in both groups.Reconstruction was performed in 507 patients; 25.6 percent received DIEP flaps (n = 183 breasts) and 74.4 percent underwent pTRAM flap surgery (n = 444 breasts). Pedicled TRAM flap patients were more likely to require abdominal closure with mesh (44.2 percent versus 8.1 percent; p < 0.001); 21.2 percent of them had a postoperative bulge and/or hernia versus 3.1 percent of DIEP flap patients; and 12.7 percent of pTRAM flap patients required surgery for hernia/bulge. Controlling for confounders, there were five times the odds of a hernia/bulge in the pTRAM flap group. DIEP flap surgery was 234 minutes longer than pTRAM flap surgery.The benefits of the pTRAM flap may be offset by the need to correct abdominal wall complications. DIEP flap reconstruction had lower donor complications but increased operative time. A cost analysis is needed to determine the most economical procedure.Therapeutic, III. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|