title: [Abdominal perforator flap (DIEP) and autologous latissimus dorsi in breast reconstruction. A retrospective comparative study about the first 60 cases of a same surgeon].
abstract: BACKGROUND
  Autologous techniques for breast reconstruction get the best cosmetic results. Aesthetic satisfaction with breast reconstruction is an important evaluation criterion. The indication is based on technical criteria (morphological, medical history) and the wishes of the patient. A rigorous evaluation of the results is necessary to assist the patients in their choice of reconstruction.
  
  
  METHODS
  Thirty-three DIEP and 27 latissimus dorsi were involved. A satisfaction questionnaire was sent to patients to collect the aesthetic evaluation of their reconstructed breast, sequelae at the donor site of the flap as well as their overall satisfaction. Post-operative photographs of the patients were subject to aesthetical evaluation by two groups of observers. Complications were analyzed.
  
  
  RESULTS
  The DIEP tends to get higher aesthetic satisfaction regarding the symmetry of the breasts and the volume of the reconstructed breast (P=0.05), and a better overall satisfaction (P=0.02). The uniformity of the colour of the reconstructed breast was considered superior by observers in the latissimus dorsi group (P=0.005). Donor site scar of DIEP was considered more unsightly while the latissimus dorsi was considered more painful (P=0.04) and uncomfortable, with more frequently contour abnormalities (P=0.03). We noted two total flap necrosis and three partial necrosis in the group DIEP, and two partial flap necrosis in the group latissimus dorsi.
  
  
  CONCLUSIONS
  This study provides evidence that can guide the patient and the surgeon in the complex process of therapeutic decision, without exempting the latter from a careful selection of indications.
authors.affiliation: Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France. Electronic address: isabelle@pluvy.com.
authors.forename: I
authors.initials: I
authors.lastname: Pluvy
authors.affiliation: Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Bellidenty
authors.affiliation: Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Ferry
authors.affiliation: Service de chirurgie maxillo-faciale et stomatologie, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Benassarou
authors.affiliation: Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Tropet
authors.affiliation: Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Pauchot
mesh_terms: D000328:Adult; D000368:Aged; D064592:Autografts; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000601:surgery; D048909:Diabetes Complications; D004954:Esthetics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D016462:Mammaplasty / Q000379:methods; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D017060:Patient Satisfaction; D061525:Perforator Flap; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D064171:Superficial Back Muscles / Q000637:transplantation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Aesthetic results; Autologous latissimus dorsi flap; Breast reconstruction; Courbe d’apprentissage; Deep inferior epigastic perforator; Deep inferior epigastric perforator; Grand dorsal autologue; Learning curve; Reconstruction mammaire; Résultats esthétiques