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논문 기본 정보

자료유형
학술저널
저자정보
Yoon Taekeun (Seoul National University) Woo Soo Jin (Seoul National University) 진웅식 (서울대학교)
저널정보
대한창상학회 Journal of Wound Management and Research Journal of Wound Management and Research Vol.17 No.3
발행연도
2021.10
수록면
169 - 177 (9page)
DOI
10.22467/jwmr.2021.01795

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Background: In advanced breast cancer, reconstruction can be performed depending on the patient’s situation, and can improve the subsequent treatment and quality of life. We examined the effect of reconstruction after palliative mastectomy on survival and quality of life.Methods: Between April 2010 and April 2021, 40 patients underwent reconstruction after palliative mastectomy for stage-IV breast cancer. To evaluate postoperative satisfaction, changes in the global health and quality-of-life scores after reconstruction were evaluated using questionnaires by the European Organisation for Research and Treatment of Cancer. The survival rate according to reconstructive surgery was estimated by the Kaplan-Meier survival analysis.Results: Reconstruction methods included free transverse rectus abdominis musculocutaneous (TRAM) flap (n=3), pedicled latissimus dorsi (LD) flap (n=3), pedicled TRAM flap (n=2), pedicled LD with pedicled vertical rectus abdominis musculocutaneous flap (n=1), tissue expander insertion (n=3), and split-thickness skin graft (n=28). There were no major complications or decreased life expectancy due to reconstruction. All patients healed well and started conventional chemoradiotherapy at 31.3 days postoperatively. The quality-of-life scores increased from 37 to 83 after reconstruction. There was no difference in the survival rates between those who underwent reconstruction with split-thickness skin graft and flap operation (P>0.05). The mean survival time postoperatively was 43.9 months.Conclusion: Compared to primary closure, reconstruction of extensive soft-tissue defects after palliative mastectomy did not affect life expectancy or delay postoperative chemoradiotherapy; it led to an improved quality of life. Therefore, the extensive defects expected after palliative mastectomy should not influence indications for reconstruction surgery.
#Breast neoplasms #Mastectomy #Palliative care #Reconstructive surgical procedures #Survival analysis

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참고문헌 (21)

참고문헌 신청
Morrogh M / 2008 / Changing indications for surgery in patients with stage IV breast cancer : a current perspective / Cancer 112:1445~1454 google schola Blanchard DK / 2008 / Association of surgery with improved survival in stage IV breast cancer patients / Ann Surg 247:732~738 google schola Chung CT / 2003 / Goals and objectives in the management of metastatic breast cancer / Oncologist 8:514~520 google schola Vieira RA / 2017 / ITADE flap after mastectomy for locally advanced breast cancer : a good choice for mid-sized defects of the chest wall, based on a systematic review of thoracoabdominal flaps / J Surg Oncol 115:949~958 google schola Durrant CA / 2011 / Mastectomy and reconstruction in stage IV breast cancer : a survey of UK breast and plastic surgeons / Breast 20:373~379 google schola

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