Immediate-DElayed AutoLogous (IDEAL) Breast Reconstruction with the DIEP Flap

Fertsch, Sonia; Munder, B; Hagouan, M; Schulz, Tino; Thamm, Oliver C.; Stambera, Peter; Abu-Ghazaleh, Alina; Schaberick, J; Andree, Christoph

doi:10.21614/chirurgia.112.4.387

Cited by 11 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[4][5][6] DIEP flaps can be performed during primary breast reconstruction in three timing schemes: delayed (no reconstruction during mastectomy), immediate (flap on the day of mastectomy), or delayedimmediate (tissue expander first during mastectomy, staged DIEP later). [7][8][9][10][11] During delayed DIEP, reconstruction is reserved until the completion of cancer treatment including chemotherapy and radiation. 9,[12][13][14] Delayed DIEP is recommended when reconstruction is not available during mastectomy or for advanced cancer such as inflammatory carcinoma.…”

mentioning

confidence: 99%

Advantages of the Delayed–Immediate Microsurgical Breast Reconstruction: Extending the Choice

Pittelkow

DeBrock

Christopher

et al. 2022

J Reconstr Microsurg

View full text Add to dashboard Cite

Background Deep inferior epigastric perforator (DIEP) reconstruction can be performed in an immediate (at time of mastectomy), delayed–immediate (immediate tissue expander followed by staged DIEP), or delayed timing following mastectomy. Avoiding flap radiation is a known benefit of the delayed–immediate approach. The purpose of this study is to evaluate patients who chose DIEP flap as the reconstructive method during initial consultation and compared characteristics of surgery in relation to their final reconstructive choice. Methods Consecutive patients having breast reconstruction from 2017 to 2019 were divided into three groups: immediate DIEP after mastectomy (Group I); delayed–immediate DIEP with tissue expander first followed by DIEP (Group II); and patients who initially chose delayed–immediate DIEP but later decided on implants for the second stage of reconstruction (Group III). Exclusion criteria were patients that had delayed DIEP (no immediate reconstruction) or had initially chose implant-based reconstruction. Results The study included 59 patients. Unilateral free flaps in Group II had shorter operative times (318 minutes) compared with Group I unilateral free flaps (488 minutes) (p = 0.024). Eleven patients (30.6%) had prophylactic mastectomies in Group I compared with none in Group II (p = 0.004). Patients who had immediate tissue expansion frequently changed their mind from DIEP to implant for second stage reconstruction frequently (52.2%). Conclusion Delayed–immediate DIEP reconstruction has several advantages over immediate DIEP flap including shorter free flap operative times. Patients commonly alter their preference for second stage reconstruction. A patient-centered advantage of delayed–immediate reconstruction is prolonging the time for patients to make their choice for the final reconstruction.

show abstract

mentioning

confidence: 99%

Advantages of the Delayed–Immediate Microsurgical Breast Reconstruction: Extending the Choice

Pittelkow

DeBrock

Christopher

et al. 2022

J Reconstr Microsurg

View full text Add to dashboard Cite

show abstract

“…With the development of plastic surgery technology, the improvement of patients' economic strength, and a better understanding of breast cancer, the purpose of treatment for breast cancer gradually changed from simply improving survival to improving survival and the quality of life. Breast reconstruction immediately after breast cancer is now a part of breast cancer's local treatment, which is being accepted by more and more patients [30][31][32]. Compared with MRM, patients with mastoscopic MRM with skin nipple-areola preservation combined with stage I prosthesis implantation under air cavity-free suspension hook not only had a beautiful appearance but also had significantly higher satisfaction than that of the classical MRM in the control group.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of modified radical mastectomy with nipple-areola preservation combined with stage I prosthesis implantation using air cavity-free suspension hook in patients with breast cancer

Liu

et al. 2021

World J Surg Onc

View full text Add to dashboard Cite

Background Mastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery. This study aimed to examine the feasibility of mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation (SMALND) compared with routine MRM. Methods This was a retrospective study of patients who underwent MRM for breast cancer at the Shengjing Hospital Affiliated to China Medical University between January 1, 2019, and June 30, 2019. Surgical outcomes, complications, satisfaction, and quality of life (Functional Assessment of Cancer Therapy-Breast [FACT-B] [Chinese version]) were compared between the two groups. Results A total of 87 patients were enrolled, with 30 underwent SMALND and 57 underwent routine MRM. The intraoperative blood loss in the SMALND group was lower than in the control group (165.3±44.1 vs. 201.4±52.7 ml, P=0.001), the operation time was longer (220.5±23.9 vs. 155.6±9.2 min, P<0.001), daily axillary drainage volume was smaller (20.2±3.6 vs. 24.1±3.0 ml, P<0.001), daily subcutaneous drainage volume was smaller (15.5±2.3 vs. 19.3±3.5 ml, P<0.001), the discharge time was shorter (7.5±1.6 vs. 9.0±1.8 days, P<0.001), and FACT-B scores were higher (83.8±5.6 vs. 72.1±4.6, P<0.001). The overall satisfaction was higher in the SMALND group than in the controls (76.7% vs. 54.4%, P=0.041). Compared with the controls, the occurrence rates of nipple and flap necrosis, upper limb edema, and paraesthesia in the SMALND group were lower within 6 months (all P<0.05). Conclusions Compared with traditional MRM, SMALND had better surgical outcomes, higher satisfaction, higher quality of life, and lower complication rates.

show abstract

“…Unter diesen Gegebenheiten wurde das „ I mmediate DE layed A uto L ogous“ ( IDEAL ) Brustrekonstruktions- Protokoll als sog . „IDEAL Concept“ entwickelt 115 116 117 (s. Abb. 4 und Patientinnenbeispiel Abb.…”

Section: „Immediate Delayed Autologous“ (Ideal)-konzeptunclassified

Rekonstruktives Vorgehen zum Brustwiederaufbau bei geplanter Bestrahlung

Wolter

Fertsch

Lisboa³

et al. 2022

Handchir Mikrochir Plast Chir

Self Cite

View full text Add to dashboard Cite

Zusammenfassung Einleitung Die ideale zeitliche und technische Vorgehensweise zur Brustrekonstruktion bei geplanter Radiatio nach vorausgegangener Mastektomie (Postmastektomie Radiotherapie; PMRT) wird weiterhin kontrovers diskutiert. Methoden Die Autoren analysierten die MEDLINE Datenbank PubMed hinsichtlich Studien, die PMRT und Brustrekonstruktion thematisierten. Die Kernaussagen dieser Studien wurden extrahiert und zusammengefasst. Ergebnisse Ein Implantat-basiertes rekonstruktives Vorgehen stellt die am wenigsten invasive zeitnahe Variante in einem PMRT-Setting dar und resultiert in einem sofortigen Brustwiederaufbau. Eine Rekonstruktion mit einem zweizeitigen Vorgehen durch ein Expander-Implantat bzw. Expander-Implantat-autologes Vorgehen ermöglicht gute bis exzellente Resultate. Verglichen mit der heterologen Vorgehensweise, resultieren autologe Rekonstruktionsverfahren in einer besseren Lebensqualität, haptisch-sensorischen Vorteilen und sind in der Regel mit einer geringeren Komplikationsrate assoziiert. Eine PMRT nach bereits durchgeführter autologer Rekonstruktion kann mit negativen ästhetischen Ergebnissen assoziiert sein. Ein delayed autologes Vorgehen kann vorteilhaft sein und sollte insbesondere bei Hochrisikopatientinnen favorisiert werden. Zusammenfassung Faktoren, die in die sorgfältige Planung einer Brustrekonstruktion bei notwendiger PMRT einbezogen werden müssen, sind chirurgischer und ästhetischer Natur, beinhalten die Lebensqualität sowie Charakteristika, Wunsch und Erwartungshaltung der jeweiligen Patientin. Die autologe Rekonstruktion sollte im Idealfall nach der PMRT stattfinden, um potentiell negativ beeinträchtigende Einflüsse auf das eigengewebliche Resultat zu vermeiden. Falls eine PMRT wahrscheinlich ist, aber möglicherweise nicht notwendig wird, kann eine immediate-delayed Vorgehensweise vorteilhaft sein.

show abstract

Immediate-DElayed AutoLogous (IDEAL) Breast Reconstruction with the DIEP Flap

Cited by 11 publications

References 15 publications

Advantages of the Delayed–Immediate Microsurgical Breast Reconstruction: Extending the Choice

Advantages of the Delayed–Immediate Microsurgical Breast Reconstruction: Extending the Choice

Feasibility of modified radical mastectomy with nipple-areola preservation combined with stage I prosthesis implantation using air cavity-free suspension hook in patients with breast cancer

Rekonstruktives Vorgehen zum Brustwiederaufbau bei geplanter Bestrahlung

Contact Info

Product

Resources

About