Background: CT angiogram (CTA) has become the preferred method for the planning of abdominal-based microsurgical breast reconstruction to gather information about location, number, caliber and trajectory of the abdominal perforators and to decrease overall flap dissection and operating room time. However, the high-level evidence to support its utility has been limited to nonrandomized retrospective and prospective studies.
Methods: Patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction were prospectively randomized to preoperative CTA and no imaging groups. Patient demographics, operative times, selected row and number of perforators for flap harvest, agreement in perforator selection between radiologist and surgeon, and clinical outcomes data were collected. Two-way ANOVA, Fisher's exact and Student's t-tests were used for statistical analysis.
Results: Overall, 37 patients with 63 flaps were included in this study. Seventeen patients had CT scan prior to surgery. Mean age was 50.5 ± 9.6 years. Flap dissection time was significantly shorter in the CT group (150.8 ± 17.8 vs 184.7 ± 25.1 min and p< 0.001). Although overall odds ratio (OR) time was also shorter in the CT group, this only reached a statistical significance in bilateral surgeries (575.9 ± 70.1 vs 641.9 ± 79.6 min and p = 0.038). Hemiabdomen side, selected DIEP row, and the number of dissected perforators did not affect the overall dissection time. Complication rates were similar between the two groups.
Conclusion: This prospective, randomized study demonstrates that preoperative CTA analysis of perforators decreases flap harvest and overall OR time with equivalent postoperative outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.bjps.2021.05.050 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Increased FGF-19 levels following explantation in women with breast implant illness.
Sci Rep
January 2025
Section General Internal Medicine, Department of Internal Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
Breast Implant Illness (BII) is characterized by a cluster of systemic and local symptoms affecting a subset of women with silicone breast implants. While symptom improvement is frequently observed following implant removal, the underlying mechanisms remain poorly understood, and the absence of reliable biomarkers complicates clinical decision-making. Here, we investigate inflammatory protein profiles in 43 women with BII, comparing pre- and post-explantation levels using the Olink Target 96 Inflammation panel and Meso Scale Discovery technology for absolute quantification.
View Article and Find Full Text PDFArterial End-To-Side Anastomosis as a Salvage Maneuver in DIEP-Flap Breast Reconstruction.
Microsurgery
February 2025
Department of Plastic and Reconstructive Surgery, Royal Free Hospital London, London, UK.
Reimbursement policies of Swiss health insurances for the surgical treatment of symptomatic breast hypertrophy: a retrospective cohort study.
Swiss Med Wkly
January 2025
Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
Background: Patients with symptomatic breast hypertrophy typically suffer from chronic back pain, recurrent skin irritation at the inframammary fold and/or low self-esteem resulting in impaired quality of life. Reduction mammaplasty has been shown to effectively treat symptomatic breast hypertrophy with high patient satisfaction. Despite the obvious benefits, reimbursement requests for reduction mammaplasty are initially often refused by the patient's health insurance company, thereby frequently resulting in additional examinations and eventually extra expenses.
View Article and Find Full Text PDFRadiological images of an advanced invasive carcinoma with mucinous aspects: A case report.
Radiol Case Rep
March 2025
Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, Italy.
Mucinous carcinoma of the breast, also known as colloid carcinoma, is an uncommon type of differentiated adenocarcinoma, representing only 2% of all invasive breast carcinomas. It usually occurs in women ≥ 60 years of age. Mucinous carcinoma is characterized by clusters of epithelial tumour cells suspended in pools of extracellular mucin and is further divided in 2 subgroups, pure and mixed.
View Article and Find Full Text PDFReducing Postbreast Reconstruction Infection Rates: Our Journey to Achieving Low Postoperative Infection Outcomes.
Cureus
December 2024
Breast Surgery, James Cook University Hospital, Middlesbrough, GBR.
Introduction: Breast surgeries are classified as clean procedures associated with a lower risk of post-operative infections; however, the reported infection rates post-breast surgeries are still significantly high. Surgical site infections (SSIs) are indeed one of the most common and serious complications following breast surgery.
Methodology: A retrospective study assessed the rate of SSIs post-breast reconstructive surgery after the implementation of the infection control protocol at James Cook University Hospital and Friarage Hospital from December 2022 to June 2024.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!