Temat: breast reconstruction

Skocz do pozycji: 1.

Tytuł:: An Evaluation of the Efficacy of Microvascular Breast Reconstruction Techniques
Autorzy:: Dobrut, Mirosław
Maciejewski, Adam
Półtorak, Stanisław
Tematy:: breast reconstruction surgery; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1396030.pdf Link otwiera się w nowym oknie
Opis:: The aim of the studywas to evaluate the efficacy of different microvascular techniques in breast reconstruction with the analysis of postoperative complications. The additional goal of the study is to analyze the quality of life of patients after microvascular breast reconstruction in comparison to the control group of patients who underwent only mastectomy without any reconstructive procedures. Also the algorithm of breast reconstruction is presented as the result of own experiences. Material and methods.Clinical material contain 2 groups of patients - women after surgical treatment in Department of Oncological and Reconstructive Surgery, Cancer Center in Gliwice in the year 2004-2009 where in 53 cases immediate and in 26 delayed breast microvascular reconstruction were performed. In all cases the diagnosis of cancer was proved by histopathological biopsy before the treatment. The type of radical resection (mastectomy) depended on histopathological type of cancer and its localization. The reconstruction - immediate vs delayed was carefully planned together with oncological treatment of the cases. Everywhere this plan was established based on carefully examinations of inferior epigastric vessels and theirs perforators. The choice between immediate and delayed microvascular reconstruction was based on prognosis and predictive factors. The QOL was analyzed due to own questionnaire when functional, aesthetics and social effects were evaluated. ResultsFree flap survival rate for all types of free flap was 95%. In cases where classic TRAM was used the rate was 85%, in cases where muscle sparring TRAM was chosen the survival rate was 100% and in remaining cases of DIEP reconstructions the rate was 89%. Generally the complications after microvascular reconstruction occurred in 13 cases (16%). In 9 cases the problems with flaps perfusion were notified. Total flap necrosis was observed in 2 TRAM and in 2 DIEP cases. In all those cases salvage surgery was administered in which the microanastomoses were explored and repaired. In 5 cases the cause of the complications was venous thrombosis, in 2 cases the vascular pedicle was kinked, and in remaining 1 the arterial thrombosis was found. The second type of complication was fat necrosis (<25% of flap volume) which was observed in 5 cases between 1 and 4 months after surgery, and it request minor plastic surgery. Donor site complications were noted in 4 cases. In two of those hernia in cicatrices was diagnosed (both were classic TRAM’s), in remaining 2 in which also fully muscle TRAM was classic the weakness of abdominal wall was observed. In group were msTRAM and DIEP were used no donor site complications occurred.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 2.

Tytuł:: Motives for the choice of not undergoing breast reconstruction
Autorzy:: Szadowska-Szlachetka, Zdzisława
Charzyńska-Gula, Marianna
Muzyczka, Katarzyna
Dobrowolska, Beata
Stanisławek, Andrzej
Tematy:: breast cancer
breast reconstruction motives; Pokaż więcej
Wydawca:: Instytut Medycyny Wsi
Powiązania:: https://bibliotekanauki.pl/articles/972568.pdf Link otwiera się w nowym oknie
Opis:: Introduction and objective. Currently, most women with less advanced breast cancer are offered operations with breast conserving treatment; however, if it is necessary to completely remove the breast, the patients may benefit from free breast reconstruction. The aim of the study was to determine the motives for breast reconstruction after mastectomy or decisive reasons for rejecting this treatment. Material and methods. The study included 241 women hospitalized in Polish oncological hospitals who were divided into two groups: 55.19% (n=133) were women after mastectomy; 44.81% (n=108) after breast reconstruction. Quantitative approach with the use of survey method was utilised. Results. Women who wished to undergo breast reconstruction were generallyy younger, better educated and more often professionally active. For women who wished to undergo breast reconstruction, the most important aspect was the willingness to improve their body image, their mental well-being, the inconvenience connected with wearing the prosthesis, better sexual relations with husband/partner, and the possibility of exposing the neckline without discomfort. The strongest correlation was found between women’s young age and their functioning in a relationship. Women after mastectomy, who decided not to undergo a breast reconstruction, were afraid of another operation, suffering, and they believed that there were more important issues. Conclusions. The study revealed a relationship between the lack of knowledge, in which hospital breast reconstruction procedure can be performed and the lack of motivation for undergoing the procedure. Women who have had knowledge of the possibility of a free breast reconstruction were younger, better educated and more often lived in the city.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 3.

Tytuł:: Personality traits and decision on breast reconstruction in women after mastectomy
Autorzy:: Miśkiewicz, Halina
Antoszewski, Bogusław
Iljin, Aleksanda
Tematy:: breast reconstruction
mastectomy
personality; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1393868.pdf Link otwiera się w nowym oknie
Opis:: The aim of the study was evaluation of the correlation between selected personality traits in women after mastectomy and their decision on breast reconstruction. Material and methods. The study was conducted between 2013‑2015, in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz, and Department of Oncological and Breast Surgery, CZMP. Comparative analysis comprised 40 patients, in whom mastectomy and breast reconstruction was done, and 40 women after breast amputation, who did not undergo reconstructive surgery. Basing on self-constructed questionnaire, five features of personality were evaluated in these women: pursue of success in life, ability to motivate others, openness to other people, impact of belonging to a social group on sense of security and the importance of opinion of others about the respondent. Apart from the questionnaire, in both groups of women a psychologic tool was used (SUPIN S30 and C30 tests) to determine the intensity of positive and negative emotions. Results. Women who did not choose the reconstructive option were statistically significantly older at mastectomy than women who underwent breast reconstruction. There were statistically significant differences between both groups in response to question on being open to other people and value of other people’s opinion. The differences in responses to question on the impact of belonging to a social group on personal sense of safety were hardly statistically significant. In psychometric studies there were significant differences in responses to SUPIN C30 test for negative emotions and S-30 for positive emotions. The level of negative emotions – feature of group A was in 47.5% in the range of high scores and in 47.5% within low and low-average scores. Among women from group B 57.5% had high scores, while 37.5% low and average scores. There were significant differences in the results of positive emotions evaluation in S-30. Women who did not undergo breast reconstruction usually had high scores, while those who decided on reconstructive surgery usually had low scores and low-high scores. Conclusions. 1. The decision on breast reconstruction after mastectomy is connected with personality features of patients. Introvert women, who base their self-opinion on opinion of others and their sense of security on belonging to a social group, rarely choose to undergo breast reconstruction. 2. Younger patients after mastectomy more frequently choose the breast reconstructive option. 3. A special algorithm of medical and psychological care in patients after mastectomy should be created to improve their further quality of life.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 4.

Tytuł:: Why Women Who Have Mastectomy Decide Not to Have Breast Reconstruction?
Autorzy:: Zieliński, Tomasz
Lorenc-Podgórska, Katarzyna
Antoszewski, Bogusław
Tematy:: mastectomy
breast reconstruction
personal choice; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1395853.pdf Link otwiera się w nowym oknie
Opis:: Breast cancer is the most common malignancy occurring in women. The treatment of breast cancer is a complex, multistep process involving surgical treatment, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and very often rehabilitation. After the treatment of the underlying disease, or still in its course, there remains a problem of deformation of the chest. Although the number of women opting for breast reconstructive surgery increases every year, the number of such procedures in Poland is low. The aim of the study was to investigate the reasons why women after amputation of the breast due to cancer are not likely to undergo breast reconstructive surgery. Material and methods. The study comprised 73 women, residents of the province of Silesia, aged between 37 and 79 years, who had undergone mastectomy for malignancy in the years 1987-2013. Results. From all of the reasons given by women for refraining from breast reconstruction, the most frequently pointed was the fear of being subjected to further surgery (38.3%). 23 women (31.5%) admitted that they were also afraid of postoperative pain. Similarly, a common response (35.6%) was that it is not essential for their mental state, and 30% of respondents fully accepted their appearance after mastectomy. Concern about the effect of failed reconstruction was reported by 24.6% of the women, and the fear that the surgery could negatively affect the process of cancer treatment by 27.4% of respondents. Lack of information about the capabilities and knowledge of breast reconstruction methods was not an important factor in decision-making. Conclusions. Most of the surveyed women who abandon breast reconstruction surgery, make this decision on the basis of more than one reasons. Fear of undergoing a second surgical procedure and pain related to it were the most important reasons for the refusal of breast reconstruction. An important factor in the decision to desist from breast reconstruction is the age of the patients.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 5.

Tytuł:: The Use of a Pedunculated, Extended Latissimus Dorsi Flap in Primary and Secondary Breast Reconstruction Procedures - Case Report
Autorzy:: Maciejewski, Adam
Ulczok, Rafał
Dobrut, Mirosław
Szumniak, Ryszard
Półtorak, Stanisław
Tematy:: breast reconstruction surgery
LD flap; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1396681.pdf Link otwiera się w nowym oknie
Opis:: The extended latissimus dorsi flap (LD) is used in breast reconstruction since the 70's. LD flap is often used in corrective surgery in cases of unsatisfactory cosmetic results after breast-conserving therapy. In our department LD flap has several uses. In addition to free microvascular flaps - which applies in breast reconstructive surgery is routine, there are clinical situations where the use of pedicled LD flap is justified. The main indications for its use are: the inability to apply microvascular flap, the general condition (diabetes, advanced atherosclerosis), smoking, previous surgery of abdominal wall, abdominal obesity, patient preferences. Approximately 30% of patients after breast reconstruction require corrective procedures. Group which uses extended LD flap account for 24 patients. In 16 cases it was used for elective breast reconstruction. In the remaining eight cases it was used in the corrective procedures symmetry and shape of the previously reconstructed breast. Based on our own experience it can be concluded that the LD flap with an alternative to microvascular techniques. Complication rate when using the LD flap is relatively low and includes: seroma and slight motor disability of the shoulder girdle.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 6.

Tytuł:: Satisfaction with life and social factors in decision‑making process on breast reconstruction in women after mastectomy
Autorzy:: Miśkiewicz, Halina
Antoszewski, Bogusław
Woźniak, Ewa
ljin, Aleksandra
Tematy:: mastectomy
satisfaction with life
breast reconstruction; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1393917.pdf Link otwiera się w nowym oknie
Opis:: The aim of the study was to analyse the correlation between satisfaction with life in women after mastectomy and motivation to undergo breast reconstruction, compared to women who after breast amputation did not decide to undergo reconstructive treatment. Material and methods. Comparative analysis comprised patients after mastectomy, who decided on breast reconstruction (40) and those who did not undergo reconstructive surgery (40). The study was conducted in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz and Department of Oncological surgery and Breast Diseases ICZMP, Łódź, between 2013‑2015. In the study the question whether higher satisfaction with life prompts decision on breast reconstruction was investigated. The Satisfaction with Life Scale (SWLS) was used, as well as an original questionnaire. The correlations between statistical parameters were evaluated using the chi-square test. Results. We have demonstrated differences between the level of satisfaction with life in patients who decided to undergo breast reconstruction and those who did not choose reconstructive surgery. The discrepancies may reflect differences in the system of values and level of satisfaction with life before reconstructive treatment and also point to potential effect of these factors on the decision to undergo surgery. Conclusions. 1. Differences in cognitive structures between ‘Amazons’ determine the decision on reconstructive treatment. 2. Transfer of information between the therapeutic team and women after mastectomy is not satisfactory. 3. Higher level of satisfaction with life has a positive effect on the decision of breast reconstruction.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 7.

Tytuł:: The intraoperative application of indocyanine green, in breast reconstructive surgery using a latissimus dorsi flap, as a preventive factor for tissue ischemia and postoperative complications
Autorzy:: Molska, Maja
Migoń, Jakub
Kolasiński, Jerzy
Cieśla, Sławomir
Murawa, Dawid
Tematy:: breast cancer
breast reconstruction
indocyanine green
latissimus dorsi flap; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/58714156.pdf Link otwiera się w nowym oknie
Opis:: Introduction: Breast cancer is the most frequent cancer among women. Nowadays, more and more women decide to undergo breast reconstruction using both implants and autologous flaps. The most important factor in avoiding bad wound healing is the preservation of blood supply and good tissue perfusion. Latissimus dorsi (LD) flap reconstruction is a commonly used method, mainly reserved for irradiated patients, delayed reconstructions, or salvage procedures. With damaged tissues, objectively assessing the conditions is much more difficult than in primary surgery. Aim: The aim of the study is to present the intraoperative application of indocyanine green (ICG), in breast reconstructive surgery with a LD flap, as a preventive factor for tissue ischemia and postoperative complications. Materials and methods: A single-center retrospective review of the outcomes of 12 patients who underwent breast reconstruction using an LD flap, with an intraoperative assessment of flap blood supply using ICG. Patient characteristics, comorbidities, and smoking habit were taken into account. Results: In two cases, after an initial assessment of tissue perfusion, it was decided to resect the distal part of the flap with less blood supply. All reconstructions were successful and the wounds healed properly. None of the patients required reoperation and there were no postoperative complications or surgical site infections. Conclusions: The use of ICG in breast reconstruction with an LD flap is an important predictor of postoperative complications, especially flap necrosis and loss of reconstruction.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 8.

Tytuł:: Bilateral risk-reducing mastectomy – surgical procedure, complications and financial benefit
Autorzy:: Gierej, Piotr
Rajca, Bartosz
Górecki-Gomoła, Adam
Tematy:: prophylactic mastectomy
risk-reducing mastectomy
breast reconstruction; Pokaż więcej
Wydawca:: Index Copernicus International
Powiązania:: https://bibliotekanauki.pl/articles/1391543.pdf Link otwiera się w nowym oknie
Opis:: Risk-reducing mastectomy is a recognized prophylactic treatment for women at high and very high risk of breast cancer development in many countries. In surgical treatment, mastectomy with simultaneous reconstruction is preferred. The most common method is simultaneous reconstruction with the use of implants, but an equivalent method with a comparable or lower complication rate is simultaneous reconstruction with own tissues, taking into account free tissue flaps. The patient should be informed about the high risk of complications, possible deterioration of the life quality and high rate of corrective reoperations. In order for this form of the most effective and financially measurable health prophylaxis to be actually implemented, it is necessary to rationally evaluate the procedure and differentiate its costs depending on the type of reconstruction performed.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 9.

Tytuł:: The influence of the rehabilitation on the female recovery after breast reconstruction
Wpływ rehabilitacji na powrót do sprawności kobiet po rekonstrukcji piersi
Autorzy:: Golec, Justyna
Opis:: Breast cancer, which is occurring more often at this time, entails adverse consequences that alters the balance between physical and mental health. The chance of restoring femine attributes is given by the treatment of breast reconstruction, which affects women aesthetic and mental health aspects.This study attempts to answer the question whether rehabilitation after breast reconstruction surgery allows a faster return to fitness, which allows women returning to their life roles.The study included 43 women aged 25 to 55 and over. Women that took part in this studies had had breast reconstruction after having mastectomy. The study lasted six months, from August 2012 to January 2013. In order to answer questions an independently complied survey has been used. Results are based on calculations using Excel.Analysis of results showed that a significant amount of respondents took rehabilitation after breast reconstruction surgery. Women showed improvement process as needed and this contributed faster recovery efficiency while affecting positively the assessment of quality of life.
Występujący coraz częściej w obecnym czasie rak piersi niesie za sobą wiele niekorzystnych następstw, które zaburzają równowagę między zdrowiem fizycznym oraz psychicznym. Szansę przywrócenia atrybutu kobiecości daje zabieg rekonstrukcji piersi, który wpływa zarówno na aspekt estetyczny jak i psychiczny kobiety. W niniejszej pracy podjęto próbę odpowiedzi na pytanie, czy rehabilitacja po zabiegu rekonstrukcji piersi pozwala na szybszy powrót do sprawności, co umożliwia powrót do pełnienia przez kobiety swoich życiowych ról.Badaniem objęto 43 kobiety w wieku od 25 do 55 oraz powyżej 55 lat. Badane kobiety były po zabiegu rekonstrukcji piersi, po wcześniejszym zabiegu mastektomii. Badania prowadzono w okresie sześciu miesięcy - od sierpnia 2012 roku do stycznia 2013 roku. W celu odpowiedzi na postawione pytania posłużono się samodzielnie sporządzoną ankietą. Wyniki zostały opracowane na podstawie obliczeń własnych przy wykorzystaniu programu Excel. Analiza wyników wykazała, że znacząca część badanych podejmuje rehabilitację po zabiegu rekonstrukcji piersi. Kobiety wskazują proces usprawniania jako potrzebny i przyczyniający się do szybszego odzyskania sprawności, zarazem pozytywnie wpływający na ocenę jakości życia.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 10.

Tytuł:: Perioperative care of a patient after prophylactic mastectomy and breast reconstruction.
Okołooperacyjna opieka nad pacjentką po profilaktycznej mastektomi i rekonstrukcji piersi.
Autorzy:: Stano, Natalia
Opis:: Introduction: Breast cancer is a serious health issue that affects many women worldwide. Raising general awareness among women allows for preventive measures to be taken and may lead to the elimination of significant risk factors and early detection of the disease. Prophylactic mastectomy is a radical but ever more common form of preventive healthcare. Appropriate care should encompass both physical and psychological aspects of a patient's well-being.Aim of the study: The aim of this study was to formulate adequate nursing and gynaecological diagnoses and to present the care process of a 45-year-old female patient, after prophylactic mastectomy with simultaneous breast reconstruction, including the patient's education for self-care at home.Materials and methods: The study utilised the individual case study method, which belongs to qualitative research methods. The following research techniques were used to collect data: the analysis of medical records, an interview with the patient and the medical staff, as well as observation and measurements. The research tools used to carry out the aforementioned data collection techniques were: medical history form, individual nursing care sheet, a medical order sheet, an observation sheet and scale forms: NRS 2002, ASA, Caprini, NRS.Results: The main problems that occured during the hospitalisation of a patient who underwent prophylactic mastectomy with simultaneous breast reconstruction were: postoperative wound pain, the risk of hypoxia and acidosis due to the saturation dropping below 95%, as well as a knowledge deficit regarding self-care, both during hospitalisation and in the home environment. Nursing problems related to the occurrence of postoperative complications such as haemorrhage, wound infection, nausea and vomiting, hydro-electrolyte balance disorders and complications related to Foley catheter insertion and vascular access were also recognised.Conclusion: The care of the patient after prophylactic mastectomy with a simultaneous breast reconstruction requires an individual approach, including not only the physical but also the psychological aspect. Providing adequate care to the patient enabled the elimination and early detection of possible complications, improved the patient's mental well-being and prepared her for self-care at home.
Wstęp: Rak piersi jest poważnym problemem zdrowotnym, dotykającym wiele kobiet na całym świecie. Wzrost ogólnej świadomości kobiet, pozwala na podjęcie działań profilaktycznych, pozwalających na wyeliminowanie znaczących czynników ryzyka i wczesne wykrycie choroby. Zabieg profilaktycznej mastektomii jest radykalną, ale coraz to częściej podejmowaną formą profilaktyki. Odpowiednia opieka nad pacjentką, powinna obejmować sferę zarówno fizyczną jak i psychiczną.Cel pracy: Celem pracy było sformułowanie odpowiednich diagnoz pielęgniarsko-ginekologicznych oraz przedstawienie procesu pielęgnowania 45-letniej pacjentki, po profilaktycznej mastektomii z jednoczasową rekonstrukcją piersi z uwzględnieniem edukacji pacjentki do samoopieki w warunkach domowych.Materiały i metody: W pracy wykorzystano metodę indywidualnego studium przypadku (ang. study case), należącą do jakościowych metod badawczych. W celu zgromadzenia danych, wykorzystano następujące techniki badawcze: analiza dokumentacji medycznej, wywiad z pacjentką i personelem medycznym, prowadzenie obserwacji oraz dokonywane pomiary. Narzędziami badawczymi, wykorzystanymi do realizacji wymienionych technik gromadzenia materiału były: historia choroby, indywidualna karta opieki pielęgniarskiej, karta zleceń lekarskich, karta obserwacyjna oraz formularze skal: NRS 20002, ASA, Capriniego, NRS.Wyniki: U pacjentki po przeprowadzonej profilaktycznej mastektomii z jednoczasową rekonstrukcją piersi, podczas hospitalizacji głównymi problemami były: ból rany pooperacyjnej, ryzyko wystąpienia niedotlenienia i kwasicy z powodu spadów saturacji poniżej 95% oraz deficyt wiedzy dotyczący samoopieki, zarówno w czasie hospitalizacji, jak i w środowisku domowym. Rozpoznano także problemy pielęgnacyjne związane z wystąpieniem powikłań pooperacyjnych, takich jak: krwotok, zakażenie rany pooperacyjnej, wystąpienie nudności i wymiotów, wystąpienie zaburzeń gospodarki wodno-elektrolitowej oraz powikłań związanych z założeniem cewnika Foley’a i dostępu naczyniowego. Wnioski: Opieka nad pacjentką po przeprowadzonym zabiegu profilaktycznej mastektomii z jednoczasową rekonstrukcją piersi, wymaga indywidualnego podejścia, obejmującego nie tylko aspekt fizyczny, ale również psychiczny. Prowadzenie odpowiedniej opieki nad pacjentką, umożliwiło wyeliminowanie i wczesne wykrycie ewentualnych powikłań, poprawę stanu psychicznego pacjentki oraz przygotowanie jej do samoopieki w warunkach domowych.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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