Skip to main content
Erschienen in: European Journal of Plastic Surgery 6/2020

21.04.2020 | Original Paper

Patient satisfaction with breast reconstruction: how much do timing and surgical technique matter?

verfasst von: Íris M. Brito, Andreia Fernandes, Carolina Andresen, Rui Barbosa, Matilde Ribeiro, Rita Valença-Filipe

Erschienen in: European Journal of Plastic Surgery | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Breast reconstruction (BR) has revealed significant benefits on physical and psychological well-being. Satisfaction is currently a key outcome on BR. This study aimed to assess the impact of timing and reconstructive technique on satisfaction, monitoring the influence of patient’s characteristics and complications.

Methods

A single-center study of women undergoing primary BR over a 4.5-year period was conducted. Demographics, clinical features, procedural data, and postoperative complications were assessed. Patient satisfaction was evaluated with the BREAST-Q™. Influence of BR timing (immediate vs. delayed) and surgical technique (autologous vs. implant-based) on satisfaction was analyzed. Univariate and multivariate analyses were performed to identify independent predictors of satisfaction.

Results

Global response rate to BREAST-Q™ was 76.1% (216 from 284 patients). Responders underwent delayed BR in 67.6%, and autologous BR in 68.5%, with a 30.1% overall complication rate. Timing demonstrated significant impact on satisfaction (p = 0.001), with delayed reconstruction showing a higher mean BREAST-Q™ score. Autologous reconstruction also had a significantly higher BREAST-Q™ (p = 0.002). Transverse rectus abdominis myocutaneous flap presented the highest score, followed by latissimus dorsi with implant, and implant-based showed the lowest satisfaction (p = 0.004). Multivariate regression analysis identified timing, minor complications, and smoking status as independent impact factors of satisfaction (p = 0.001, p = 0.043, and p = 0.011, respectively).

Conclusions

Timing significantly affected satisfaction (delayed reconstruction evidencing positive influence). Technique did not reach significance as independent predictor. Smoking and minor complications showed negative influence. Meaningful satisfaction with delayed reconstruction may encourage BR in the majority of patients, even those with medical or oncologic risks that precluded immediate reconstruction.
Level of evidence: Not ratable.
Literatur
1.
Zurück zum Zitat Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424
2.
Zurück zum Zitat Alderman AK, Kuhn LE, Lowery JC, Wilkins EG (2007) Does patient satisfaction with breast reconstruction change over time? Two-year results of the Michigan Breast Reconstruction Outcomes Study. J Am Coll Surg 204:7–12PubMed Alderman AK, Kuhn LE, Lowery JC, Wilkins EG (2007) Does patient satisfaction with breast reconstruction change over time? Two-year results of the Michigan Breast Reconstruction Outcomes Study. J Am Coll Surg 204:7–12PubMed
3.
Zurück zum Zitat Chen W, Lv X, Xu X, Gao X, Wang B (2018) Meta-analysis for psychological impact of breast reconstruction in patients with breast cancer. Breast Cancer 25:464–469PubMed Chen W, Lv X, Xu X, Gao X, Wang B (2018) Meta-analysis for psychological impact of breast reconstruction in patients with breast cancer. Breast Cancer 25:464–469PubMed
4.
Zurück zum Zitat Filip CI, Jecan CR, Raducu L, Neagu TP, Florescu IP (2017) Immediate versus delayed breast reconstruction for postmastectomy patients. Controversies and solutions. Chirurgia (Bucur) 112:378–386 Filip CI, Jecan CR, Raducu L, Neagu TP, Florescu IP (2017) Immediate versus delayed breast reconstruction for postmastectomy patients. Controversies and solutions. Chirurgia (Bucur) 112:378–386
5.
Zurück zum Zitat D'Souza N, Darmanin G, Fedorowicz Z (2011) Immediate versus delayed reconstruction following surgery for breast cancer. Cochrane Database Syst Rev 7:CD008674 D'Souza N, Darmanin G, Fedorowicz Z (2011) Immediate versus delayed reconstruction following surgery for breast cancer. Cochrane Database Syst Rev 7:CD008674
6.
Zurück zum Zitat Juhl AA, Christensen S, Zachariae R, Damsgaard TE (2017) Unilateral breast reconstruction after mastectomy—patient satisfaction, aesthetic outcome and quality of life. Acta Oncol 56:225–231PubMed Juhl AA, Christensen S, Zachariae R, Damsgaard TE (2017) Unilateral breast reconstruction after mastectomy—patient satisfaction, aesthetic outcome and quality of life. Acta Oncol 56:225–231PubMed
7.
Zurück zum Zitat Thamm OC, Andree C (2018) Immediate versus delayed breast reconstruction: evolving concepts and evidence base. Clin Plast Surg 45:119–127PubMed Thamm OC, Andree C (2018) Immediate versus delayed breast reconstruction: evolving concepts and evidence base. Clin Plast Surg 45:119–127PubMed
8.
Zurück zum Zitat Nelson JA, Lee IT, Disa JJ (2018) The functional impact of breast reconstruction: an overview and update. Plast Reconstr Surg Glob Open 6:e1640PubMedPubMedCentral Nelson JA, Lee IT, Disa JJ (2018) The functional impact of breast reconstruction: an overview and update. Plast Reconstr Surg Glob Open 6:e1640PubMedPubMedCentral
9.
Zurück zum Zitat Craig E, Shah A, Persing S, Salomon J, Fusi S (2015) Simultaneous expander and deep inferior epigastric perforator reconstruction: indications and alloderm sling technique for protecting the anastomosis. Plast Aesthet Res 2:63–68 Craig E, Shah A, Persing S, Salomon J, Fusi S (2015) Simultaneous expander and deep inferior epigastric perforator reconstruction: indications and alloderm sling technique for protecting the anastomosis. Plast Aesthet Res 2:63–68
10.
Zurück zum Zitat Saulis AS, Mustoe TA, Fine NA (2007) A retrospective analysis of patient satisfaction with immediate postmastectomy breast reconstruction: comparison of three common procedures. Plast Reconstr Surg 119:1669–1676PubMed Saulis AS, Mustoe TA, Fine NA (2007) A retrospective analysis of patient satisfaction with immediate postmastectomy breast reconstruction: comparison of three common procedures. Plast Reconstr Surg 119:1669–1676PubMed
11.
Zurück zum Zitat Yueh JH, Slavin SA, Adesiyun T, Nyame TT, Gautam S, Morris DJ, Tobias AM, Lee BT (2010) Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg 125:1585–1595PubMed Yueh JH, Slavin SA, Adesiyun T, Nyame TT, Gautam S, Morris DJ, Tobias AM, Lee BT (2010) Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg 125:1585–1595PubMed
12.
Zurück zum Zitat Kazzazi F, Haggie R, Forouhi P, Kazzazi N, Wyld L, Malata CM (2018) A comparison of patient satisfaction (using the BREAST-Q questionnaire) with bilateral breast reconstruction following risk-reducing or therapeutic mastectomy. J Plast Reconstr Aesthet Surg 71:1324–1331PubMed Kazzazi F, Haggie R, Forouhi P, Kazzazi N, Wyld L, Malata CM (2018) A comparison of patient satisfaction (using the BREAST-Q questionnaire) with bilateral breast reconstruction following risk-reducing or therapeutic mastectomy. J Plast Reconstr Aesthet Surg 71:1324–1331PubMed
13.
Zurück zum Zitat Yoon AP, Qi J, Brown DL, Kim HM, Hamill JB, Erdmann-Sager J, Pusic AL, Wilkins EG (2018) Outcomes of immediate versus delayed breast reconstruction: results of a multicenter prospective study. Breast 37:72–79PubMed Yoon AP, Qi J, Brown DL, Kim HM, Hamill JB, Erdmann-Sager J, Pusic AL, Wilkins EG (2018) Outcomes of immediate versus delayed breast reconstruction: results of a multicenter prospective study. Breast 37:72–79PubMed
14.
Zurück zum Zitat Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG (2008) Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. Ann Surg 247:1019–1028PubMed Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG (2008) Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. Ann Surg 247:1019–1028PubMed
15.
Zurück zum Zitat Platt J, Zhong T (2018) Patient-centered breast reconstruction based on health-related quality-of-life evidence. Clin Plast Surg 45:137–143PubMed Platt J, Zhong T (2018) Patient-centered breast reconstruction based on health-related quality-of-life evidence. Clin Plast Surg 45:137–143PubMed
16.
Zurück zum Zitat Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124:345–353PubMed Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124:345–353PubMed
17.
Zurück zum Zitat Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, Kim HM, Qi J, Albornoz C, Klassen AF, Wilkins EG (2017) Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol 35:2499–2506PubMedPubMedCentral Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, Kim HM, Qi J, Albornoz C, Klassen AF, Wilkins EG (2017) Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol 35:2499–2506PubMedPubMedCentral
18.
Zurück zum Zitat Pinsolle V, Grinfeder C, Mathoulin-Pelissier S, Faucher A (2006) Complications analysis of 266 immediate breast reconstructions. J Plast Reconstr Aesthet Surg 59:1017–1024PubMed Pinsolle V, Grinfeder C, Mathoulin-Pelissier S, Faucher A (2006) Complications analysis of 266 immediate breast reconstructions. J Plast Reconstr Aesthet Surg 59:1017–1024PubMed
19.
Zurück zum Zitat Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL (2018) Long-term patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg 153:891–899PubMedPubMedCentral Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL (2018) Long-term patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg 153:891–899PubMedPubMedCentral
20.
Zurück zum Zitat Dean NR, Crittenden T (2016) A five year experience of measuring clinical effectiveness in a breast reconstruction service using the BREAST-Q patient reported outcomes measure: a cohort study. J Plast Reconstr Aesthet Surg 69:1469–1477PubMed Dean NR, Crittenden T (2016) A five year experience of measuring clinical effectiveness in a breast reconstruction service using the BREAST-Q patient reported outcomes measure: a cohort study. J Plast Reconstr Aesthet Surg 69:1469–1477PubMed
21.
Zurück zum Zitat Lee BT, Agarwal JP, Ascherman JA et al (2017) Evidence-based clinical practice guideline: autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps. Plast Reconstr Surg 140:651e–664ePubMed Lee BT, Agarwal JP, Ascherman JA et al (2017) Evidence-based clinical practice guideline: autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps. Plast Reconstr Surg 140:651e–664ePubMed
22.
Zurück zum Zitat Jeong W, Lee S, Kim J (2018) Meta-analysis of flap perfusion and donor site complications for breast reconstruction using pedicled versus free TRAM and DIEP flaps. Breast 38:45–51PubMed Jeong W, Lee S, Kim J (2018) Meta-analysis of flap perfusion and donor site complications for breast reconstruction using pedicled versus free TRAM and DIEP flaps. Breast 38:45–51PubMed
23.
Zurück zum Zitat Browne JP, Jeevan R, Gulliver-Clarke C, Pereira J, Caddy CM, van der Meulen JHP (2017) The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer. Cancer 123:3460–3467PubMed Browne JP, Jeevan R, Gulliver-Clarke C, Pereira J, Caddy CM, van der Meulen JHP (2017) The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer. Cancer 123:3460–3467PubMed
24.
Zurück zum Zitat Klassen AF, Pusic AL, Scott A, Klok J, Cano SJ (2009) Satisfaction and quality of life in women who undergo breast surgery: a qualitative study. BMC Womens Health 9:11PubMedPubMedCentral Klassen AF, Pusic AL, Scott A, Klok J, Cano SJ (2009) Satisfaction and quality of life in women who undergo breast surgery: a qualitative study. BMC Womens Health 9:11PubMedPubMedCentral
25.
Zurück zum Zitat Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, Cordeiro PG (2007) Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg 120:823–837PubMed Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, Cordeiro PG (2007) Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg 120:823–837PubMed
26.
Zurück zum Zitat Pusic AL et al (2006) Measuring quality of life in breast surgery: content development of a new modular system to capture patient-reported outcomes (the MSKCC Breast-Q). ISOQOL Annual Meeting 2006 Pusic AL et al (2006) Measuring quality of life in breast surgery: content development of a new modular system to capture patient-reported outcomes (the MSKCC Breast-Q). ISOQOL Annual Meeting 2006
27.
Zurück zum Zitat Cano SJ, Klassen A, Pusic AL (2009) The science behind quality-of-life measurement: a primer for plastic surgeons. Plast Reconstr Surg 123:98e–106ePubMed Cano SJ, Klassen A, Pusic AL (2009) The science behind quality-of-life measurement: a primer for plastic surgeons. Plast Reconstr Surg 123:98e–106ePubMed
28.
Zurück zum Zitat Colakoglu S, Khansa I, Curtis MS, Yueh JH, Ogunleye A, Haewyon C, Tobias AM, Lee BT (2011) Impact of complications on patient satisfaction in breast reconstruction. Plast Reconstr Surg 127:1428–1436PubMed Colakoglu S, Khansa I, Curtis MS, Yueh JH, Ogunleye A, Haewyon C, Tobias AM, Lee BT (2011) Impact of complications on patient satisfaction in breast reconstruction. Plast Reconstr Surg 127:1428–1436PubMed
29.
Zurück zum Zitat Spiegel AJ, Eldor L (2010) SIEA flap breast reconstruction. In: Hall-Findlay EJ, Evans GRD (eds) Aesthetic and reconstructive surgery of the breast. Saunders Elsevier, pp 147–159 Spiegel AJ, Eldor L (2010) SIEA flap breast reconstruction. In: Hall-Findlay EJ, Evans GRD (eds) Aesthetic and reconstructive surgery of the breast. Saunders Elsevier, pp 147–159
30.
Zurück zum Zitat Alderman AK, Wilkins EG, Kim HM, Lowery JC (2002) Complications in postmastectomy breast reconstruction: two-year results of the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg 109:2265–2274PubMed Alderman AK, Wilkins EG, Kim HM, Lowery JC (2002) Complications in postmastectomy breast reconstruction: two-year results of the Michigan Breast Reconstruction Outcome Study. Plast Reconstr Surg 109:2265–2274PubMed
31.
Zurück zum Zitat Ng SK, Hare RM, Kuang RJ, Smith KM, Brown BJ, Hunter-Smith DJ (2016) Breast reconstruction post mastectomy: patient satisfaction and decision making. Ann Plast Surg 76:640–644PubMed Ng SK, Hare RM, Kuang RJ, Smith KM, Brown BJ, Hunter-Smith DJ (2016) Breast reconstruction post mastectomy: patient satisfaction and decision making. Ann Plast Surg 76:640–644PubMed
32.
Zurück zum Zitat Cohen WA, Mundy LR, Ballard TN, Klassen A, Cano SJ, Browne J, Pusic AL (2016) The BREAST-Q in surgical research: a review of the literature 2009-2015. J Plast Reconstr Aesthet Surg 69:149–162PubMed Cohen WA, Mundy LR, Ballard TN, Klassen A, Cano SJ, Browne J, Pusic AL (2016) The BREAST-Q in surgical research: a review of the literature 2009-2015. J Plast Reconstr Aesthet Surg 69:149–162PubMed
33.
Zurück zum Zitat Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL (2017) Breast cancer and reconstruction: normative data for interpreting the BREAST-Q. Plast Reconstr Surg 139:1046e–1055ePubMedPubMedCentral Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL (2017) Breast cancer and reconstruction: normative data for interpreting the BREAST-Q. Plast Reconstr Surg 139:1046e–1055ePubMedPubMedCentral
34.
Zurück zum Zitat Liu LQ, Branford OA, Mehigan S (2018) BREAST-Q measurement of the patient perspective in oncoplastic breast surgery: a systematic review. Plast Reconstr Surg Glob Open 6:e1904PubMedPubMedCentral Liu LQ, Branford OA, Mehigan S (2018) BREAST-Q measurement of the patient perspective in oncoplastic breast surgery: a systematic review. Plast Reconstr Surg Glob Open 6:e1904PubMedPubMedCentral
35.
Zurück zum Zitat Toyserkani NM, Jørgensen MG, Tabatabaeifar S, Damsgaard T, Sørensen JA (2020) Autologous versus implant-based breast reconstruction: a systematic review and meta-analysis of Breast-Q patient-reported outcomes. J Plast Reconstr Aesthet Surg 73:278–285PubMed Toyserkani NM, Jørgensen MG, Tabatabaeifar S, Damsgaard T, Sørensen JA (2020) Autologous versus implant-based breast reconstruction: a systematic review and meta-analysis of Breast-Q patient-reported outcomes. J Plast Reconstr Aesthet Surg 73:278–285PubMed
36.
Zurück zum Zitat Zhong T, Hu J, Bagher S, Vo A, OʼNeill AC, Butler K, Novak CB, Hofer SO, Metcalfe KA (2016) A comparison of psychological response, body image, sexuality, and quality of life between immediate and delayed autologous tissue breast reconstruction: a prospective long-term outcome study. Plast Reconstr Surg 138:772–780PubMed Zhong T, Hu J, Bagher S, Vo A, OʼNeill AC, Butler K, Novak CB, Hofer SO, Metcalfe KA (2016) A comparison of psychological response, body image, sexuality, and quality of life between immediate and delayed autologous tissue breast reconstruction: a prospective long-term outcome study. Plast Reconstr Surg 138:772–780PubMed
37.
Zurück zum Zitat Eltahir Y, Werners LL, Dreise MM, Zeijlmans van Emmichoven IA, Werker PM, de Bock GH (2015) Which breast is the best? Successful autologous or alloplastic breast reconstruction: patient-reported quality-of-life outcomes. Plast Reconstr Surg 135:43–50PubMed Eltahir Y, Werners LL, Dreise MM, Zeijlmans van Emmichoven IA, Werker PM, de Bock GH (2015) Which breast is the best? Successful autologous or alloplastic breast reconstruction: patient-reported quality-of-life outcomes. Plast Reconstr Surg 135:43–50PubMed
38.
Zurück zum Zitat Santosa KB, Qi J, Kim HM, Hamill JB, Pusic AL, Wilkins EG (2016) Effect of patient age on outcomes in breast reconstruction: results from a multicenter prospective study. J Am Coll Surg 223:745–754PubMedPubMedCentral Santosa KB, Qi J, Kim HM, Hamill JB, Pusic AL, Wilkins EG (2016) Effect of patient age on outcomes in breast reconstruction: results from a multicenter prospective study. J Am Coll Surg 223:745–754PubMedPubMedCentral
39.
Zurück zum Zitat Pirro O, Mestak O, Vindigni V, Sukop A, Hromadkova V, Nguyenova A, Vitova L, Bassetto F (2017) Comparison of patient-reported outcomes after implant versus autologous tissue breast reconstruction using the BREAST-Q. Plast Reconstr Surg Glob Open 5:e1217PubMedPubMedCentral Pirro O, Mestak O, Vindigni V, Sukop A, Hromadkova V, Nguyenova A, Vitova L, Bassetto F (2017) Comparison of patient-reported outcomes after implant versus autologous tissue breast reconstruction using the BREAST-Q. Plast Reconstr Surg Glob Open 5:e1217PubMedPubMedCentral
40.
Zurück zum Zitat Nelson JA, Allen RJ Jr, Polanco T et al (2019) Long-term patient-reported outcomes following postmastectomy breast reconstruction: an 8-year examination of 3268 patients. Ann Surg 270:473–483PubMed Nelson JA, Allen RJ Jr, Polanco T et al (2019) Long-term patient-reported outcomes following postmastectomy breast reconstruction: an 8-year examination of 3268 patients. Ann Surg 270:473–483PubMed
41.
Zurück zum Zitat Murphy BD, Kerrebijn I, Farhadi J, Masia J, Hofer SOP (2018) Indications and controversies for abdominally-based complete autologous tissue breast reconstruction. Clin Plast Surg 45:83–91PubMed Murphy BD, Kerrebijn I, Farhadi J, Masia J, Hofer SOP (2018) Indications and controversies for abdominally-based complete autologous tissue breast reconstruction. Clin Plast Surg 45:83–91PubMed
42.
Zurück zum Zitat Benditte-Klepetko HC, Lutgendorff F, Kastenbauer T, Deutinger M, van der Horst CM (2014) Analysis of patient satisfaction and donor-site morbidity after different types of breast reconstruction. Scand J Surg 103:249–255PubMed Benditte-Klepetko HC, Lutgendorff F, Kastenbauer T, Deutinger M, van der Horst CM (2014) Analysis of patient satisfaction and donor-site morbidity after different types of breast reconstruction. Scand J Surg 103:249–255PubMed
43.
Zurück zum Zitat Barone M, Cogliandro A, Signoretti M, Persichetti P (2018) Analysis of symmetry stability following implant-based breast reconstruction and contralateral management in 582 patients with long-term outcomes. Aesthet Plast Surg 42:936–940 Barone M, Cogliandro A, Signoretti M, Persichetti P (2018) Analysis of symmetry stability following implant-based breast reconstruction and contralateral management in 582 patients with long-term outcomes. Aesthet Plast Surg 42:936–940
44.
Zurück zum Zitat Andrade WN, Baxter N, Semple JL (2001) Clinical determinants of patient satisfaction with breast reconstruction. Plast Reconstr Surg 107:46–54PubMed Andrade WN, Baxter N, Semple JL (2001) Clinical determinants of patient satisfaction with breast reconstruction. Plast Reconstr Surg 107:46–54PubMed
45.
Zurück zum Zitat Wilkins EG, Hamill JB, Kim HM, Kim JY, Greco RJ, Qi J, Pusic AL (2018) Complications in postmastectomy breast reconstruction: one-year outcomes of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study. Ann Surg 267:164–170PubMedPubMedCentral Wilkins EG, Hamill JB, Kim HM, Kim JY, Greco RJ, Qi J, Pusic AL (2018) Complications in postmastectomy breast reconstruction: one-year outcomes of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study. Ann Surg 267:164–170PubMedPubMedCentral
46.
Zurück zum Zitat Bennett KG, Qi J, Kim HM, Hamill JB, Pusic AL, Wilkins EG (2018) Comparison of 2-year complication rates among common techniques for postmastectomy breast reconstruction. JAMA Surg 153:901–908PubMedPubMedCentral Bennett KG, Qi J, Kim HM, Hamill JB, Pusic AL, Wilkins EG (2018) Comparison of 2-year complication rates among common techniques for postmastectomy breast reconstruction. JAMA Surg 153:901–908PubMedPubMedCentral
47.
Zurück zum Zitat Sanati-Mehrizy P, Massenburg BB, Rozehnal JM, Gupta N, Rosa JH, Ingargiola MJ, Taub PJ (2015) A comparison of postoperative outcomes in immediate versus delayed reconstruction after mastectomy. Eplasty 15:e44PubMedPubMedCentral Sanati-Mehrizy P, Massenburg BB, Rozehnal JM, Gupta N, Rosa JH, Ingargiola MJ, Taub PJ (2015) A comparison of postoperative outcomes in immediate versus delayed reconstruction after mastectomy. Eplasty 15:e44PubMedPubMedCentral
48.
Zurück zum Zitat Beugels J, Kool M, Hoekstra LT, Heuts EM, Tuinder SMH, van der Hulst RRWJ, Piatkowski A (2018) Quality of life of patients after immediate or delayed autologous breast reconstruction: a multicenter study. Ann Plast Surg 81:523–527PubMed Beugels J, Kool M, Hoekstra LT, Heuts EM, Tuinder SMH, van der Hulst RRWJ, Piatkowski A (2018) Quality of life of patients after immediate or delayed autologous breast reconstruction: a multicenter study. Ann Plast Surg 81:523–527PubMed
Metadaten
Titel
Patient satisfaction with breast reconstruction: how much do timing and surgical technique matter?
verfasst von
Íris M. Brito
Andreia Fernandes
Carolina Andresen
Rui Barbosa
Matilde Ribeiro
Rita Valença-Filipe
Publikationsdatum
21.04.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Plastic Surgery / Ausgabe 6/2020
Print ISSN: 0930-343X
Elektronische ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-020-01663-7

Weitere Artikel der Ausgabe 6/2020

European Journal of Plastic Surgery 6/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.