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Assessment of the risk of bulge/hernia formation after abdomen-based microsurgical breast reconstruction with the aid of preoperative computed tomographic angiography-derived morphometric measurements
- Title
- Assessment of the risk of bulge/hernia formation after abdomen-based microsurgical breast reconstruction with the aid of preoperative computed tomographic angiography-derived morphometric measurements
- Authors
- Park, Jin-Woo; Lee, Hojune; Jeon, Byung-Joon; Pyon, Jai-Kyong; Mun, Goo-Hyun
- Ewha Authors
- 박진우
- SCOPUS Author ID
- 박진우
- Issue Date
- 2020
- Journal Title
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
- ISSN
- 1748-6815
1878-0539
- Citation
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY vol. 73, no. 9, pp. 1665 - 1674
- Keywords
- Bulge; Hernia; Breast reconstruction; DIEP; TRAM
- Publisher
- ELSEVIER SCI LTD
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: No preoperative risk assessment tool is available to predict postoperative bulge formation after abdomen-based breast reconstruction. The authors evaluated the association between clinical variables and morphometric measurements on preoperative computed tomographic (CT) angiography and postoperative abdominal wall morbidity. Methods: The authors evaluated all cases of postoperative bulge/hernia and normal controls in patients who underwent preoperative CT angiography and abdomen-based microsurgical breast reconstruction between July 2009 and January 2018. CT-based abdominal wall profiles, including abdominal wall protrusion, abdominopelvic cavity cross-sectional area (CSA), and abdominopelvic cavity-to-total body CSA ratio, were obtained and analyzed. A novel risk stratification scoring system to stratify the risk of bulge/hernia was developed. Results: Among 463 patients who underwent abdomen-based breast reconstruction, 23 were diagnosed as having a bulge/hernia. Age (OR 2.912; 95% CI 1.157-7.333), lateral row perforator (OR 5.065; 95% CI 1.834-13.986), and abdominal wall protrusion (OR 3.687; 95% CI 1.494-9.100) were significant risk factors associated with postoperative bulge/hernia in the multivariate analysis. Using the risk stratification scoring system, the incidence rates of postoperative bulge/hernia were 1.7%, 4.8%, and 19.0% for low-, intermediate-, and high-risk patients, respectively (p < 0.001). Conclusions: Age, lateral row perforator, and abdominal wall protrusion were significantly associated with postoperative bulge/hernia formation after abdomen-based microsurgical breast reconstruction. The authors' risk score based on the three variables may help predict and minimize donor-site morbidity. (c) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
- DOI
- 10.1016/j.bjps.2020.05.019
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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