Use of the Venous Coupler in Breast Reconstruction by Means of a Deep Inferior Epigastric Perforator: Reduction of Surgery Length and Venous Thromboses ?
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Rate of venous thrombosis
研究概览
简要总结
This is a retrospective study performed on medical records, in order to compare the number of venous thromboses, the surgery duration, the complications rate and the duration of anastomosis in breast reconstructive surgeries by the DIEP (Deep Inferior Epigastric Perforator Flap) technique, with or without the use of a venous coupler.
详细描述
Breast cancer is the most common and deadliest cancer among women in Belgium. Women with invasive cancer may be offered a total mastectomy with or without adjuvant/neoadjuvant therapy, and with or without breast reconstruction. It is obvious that the loss of a breast can impact the self-image, hence the importance of informing the patient about the possibilities of breast reconstruction. Between 14 and 20% of women choose to resort to reconstruction.
Different types of breast reconstruction exist: prosthetic reconstruction, lipolifting and flap reconstruction (of large dorsal, gluteus maximus, rectus abdominis muscle and "DIEP").
DIEP (Deep Inferior Epigastric Perforator Flap) presents numerous advantages. It consists in the use of a free cutaneo-greasy flap taken from the abdomen, without muscle removed. The abdominal skin has a similar appearance to the breast skin and, thanks to the presence of fat, the missing volume is replaced by a living tissue. Weakness of the abdominal wall is also avoided. However, it remains a surgical procedure with possible complications.
There are several steps in this surgery. The first is to dissect the abdominal flap by talking the skin and subcutaneous fat and isolating one or two branches of the lower epigastric artery and one or two veins. The donor area is then closed. The second step is to prepare the recipient area, ie dissect the artery that will be anastomosed with the lower deep epigastric artery.This artery can be the intern mammary artery, the thoraco-dorsal artery or more rarely the axillary artery. The third step consists of performing arterial and venous anastomoses and checking the quality of these.
Two microanastomoses must thus be performed: arterial and venous. The classic technique, the most used, is to suture the 2 veins. Alternatively, a coupler device can be used to perform the venous anastomosis.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 25 Years 至 75 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Total mastectomy with mammary reconstruction by the DIEP technique
- •Patients treated within the CHU Brugmann Hospital
- •Patients treated between 01/01/2017 and 01/09/2017
排除标准
- 未提供
结局指标
主要结局
Rate of venous thrombosis
时间窗: Up to 1 week after mammary reconstruction surgery
Rate of venous thrombosis
Surgery duration
时间窗: At the date of mammary reconstruction surgery.
Duration of the mammary reconstruction surgery with the DIEP technique
Anastomosis duration
时间窗: At the date of mammary reconstruction surgery.
Duration of the anastomosis during the mammary reconstruction surgery
次要结局
- Body mass index(At the date of mammary reconstruction surgery.)
- Tabagism(At the date of mammary reconstruction surgery.)
- Immediate of differed reconstruction(At the date of mammary reconstruction surgery.)
- Unilateral or Bilateral DIEP(At the date of mammary reconstruction surgery.)
- Type of cancer treatment(At the date of mammary reconstruction surgery.)
- Age(At the date of mammary reconstruction surgery.)
- Co-morbidity : cardio-vascular disease(At the date of mammary reconstruction surgery.)
- Co-morbidity : medical history of venous thrombosis(At the date of mammary reconstruction surgery.)
- Co-morbidity : diabetes(At the date of mammary reconstruction surgery.)
- Medical complications (yes/no)(Up to one week after mammary reconstruction surgery)
研究者
Socorro ORTIZ
Head of clinic
Brugmann University Hospital