医学
乳房再造术
整形外科
耳鼻咽喉科
生活质量(医疗保健)
患者满意度
植入
外科
乳房切除术
梅德林
作者
Max Dieterich,J. Angres,Angrit Stachs,Änne Glass,Toralf Reimer,Bernd Gerber,Johannes Stubert
标识
DOI:10.1007/s00266-015-0520-x
摘要
Implant-based breast reconstructions (IBBR) using alternatives to acellular dermal matrixes are increasing. Data on complications are limited, and information concerning health-related quality of life (HR-QoL) following the use of these synthetic meshes do not exist. Between January 2006 and January 2013, patients undergoing immediate or delayed-immediate IBBR with or without titanium covered polypropylene mesh (TiLOOP® Bra) were investigated. HR-QoL was assessed using the validated self-reporting BREAST-Q questionnaire. Patient demographics and complications were evaluated retrospectively. Stepwise regression backward elimination analysis was performed to identify influential factors on each BREAST-Q domain. Of the 90 women, 42 had IBBR alone and 48 in combination with TiLOOP® Bra. The mean follow-up was 18 months in the TiLOOP® Bra and 17.5 months in the implant alone group (p = 0.827). The overall complication rate was 21.1 %, with 14.6 % in the TiLOOP® Bra and in 28.6 % in the implant alone group (p = 0.105). Capsular contraction rate was 4.4 % in the TiLOOP® Bra and 16.7 % in the implant alone group (p = 0.052). The analysis of the HR-QoL showed no significant differences between the groups. Surgeries prior to IBBR had a positive influence on HR-QoL. TiLOOP® Bra was associated with a negative effect on “satisfaction with breast” (β = −5.72; p < 0.001), as it was no longer observed for “satisfaction with outcome” and other domains. Using TiLOOP® Bra showed similar complication and satisfaction rates but a negative effect on “satisfaction with breast.” TiLOOP® Bra might be used in selected patients, but is not meant to overcome all restrictions of IBBR. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
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