Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite thei...
Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. Methods A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. Results The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was $0.71{\pm}0.23$. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of $0.66{\pm}0.11$. The 25 patients who underwent a contralateral procedure had a ratio of $0.96{\pm}0.30$. The adjusted ratio of the final flap weight to the initial flap weight was $0.66{\pm}0.12$. Conclusions Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.
Background Slim patients or those with large breasts may be ineligible for breast reconstruction with an abdominal flap, as the volume of the flap may be insufficient. This study aimed to establish that abdominal tissue-based breast reconstruction can be well suited for Korean patients, despite their thin body habitus. Methods A total of 252 patients who underwent postmastectomy breast reconstruction with an abdominal flap from October 2006 to May 2013 were retrospectively reviewed. The patients' age and body mass index were analyzed, and a correlation analysis was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. Results The average weights of the mastectomy specimen and initial abdominal flap were 451.03 g and 644.95 g, respectively. The ratio of the weight of the mastectomy specimen to that of the initial flap was $0.71{\pm}0.23$. There was a strong positive linear relationship between the weight of the mastectomy specimen and that of the initial flap (Pearson correlation coefficient, 0.728). Thirty nulliparous patients had a final-to-initial flap weight ratio of $0.66{\pm}0.11$. The 25 patients who underwent a contralateral procedure had a ratio of $0.96{\pm}0.30$. The adjusted ratio of the final flap weight to the initial flap weight was $0.66{\pm}0.12$. Conclusions Breast weight had a strong positive relationship with abdominal flap weight in Koreans. Abdominal flaps provided sufficient soft tissue for breast reconstruction in most Korean patients, including nulliparous patients. However, when the mastectomy weight is estimated to be >700 g, a contralateral reduction procedure may be considered.
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문제 정의
This study aimed to establish that abdominal tissue– based breast reconstruction can be well suited for Korean patients with thin body habitus.
가설 설정
One of the limitations of our study was that we analyzed the weight of the specimen and flaps, instead of the volume. Although an analysis with volume measurements may have been more valuable, it is not easy to measure the volume of a flap under sterile conditions.
제안 방법
Abdominal flaps are abdominally-based free flaps, including free TRAM, DIEP, and superficial inferior epigastric artery (SIEA) flaps. All operations were performed by a single surgeon (J.S.E.), and all patients underwent immediate postmastectomy breast reconstruction. Patients with delayed breast reconstructions were excluded because we could not precisely determine the weight of their previous mastectomy specimen.
대상 데이터
Data were collected and reviewed from 252 patients who underwent postmastectomy breast reconstruction with a lower abdominal flap from October 2006 to May 2013. All patients were Korean and lived in the Republic of Korea. Abdominal flaps are abdominally-based free flaps, including free TRAM, DIEP, and superficial inferior epigastric artery (SIEA) flaps.
Among the 252 patients, DIEP or SIEA flaps were used in 169 patients (DIEP, 144; SIEA, 15) and muscle-sparing free TRAM flaps were used in 83 patients. The baseline data are summarized in Table 1.
Our Institutional Review Board approved this study. Data were collected and reviewed from 252 patients who underwent postmastectomy breast reconstruction with a lower abdominal flap from October 2006 to May 2013. All patients were Korean and lived in the Republic of Korea.
데이터처리
Correlation analysis with the Pearson correlation coefficient was performed between the weight of the mastectomy specimen and that of the initial abdominal flap. The same analyses were also performed between BMI and the weight of the mastectomy specimen and between BMI and the initial flap weight.
이론/모형
In insetting the flap, the authors used the vertical inset method. The side of the flap where the umbilicus is placed is placed on the lateral side and the pubic side of the flap is placed medially.
성능/효과
As our results demonstrated, patients with a small abdomen tended to have small breasts, whereas patients with large breasts tended to have a larger abdomen. Furthermore, the ratio of the weight of the mastectomy specimen to that of the abdominal flap was 0.
In conclusion, breast weight had a strong positive relationship with abdominal flap weight in Koreans. TRAM and DIEP flaps alone provided sufficient tissue for breast reconstruction, except when the patients’ mastectomy weight was roughly > 700 g.
참고문헌 (25)
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