title: [Setting of a breast autologous microsurgical reconstructive surgery evolution in 20 years and review of 1138 cases].
abstract: The authors conducted a retrospective study of breast reconstruction with DIEP free flap between 1994 and 2014 by a single team.
  
  
  METHODS
  A retrospective analysis of all operative charts and hospitalization was conducted for the period from 1994 to 2014. The number of cases per year, the complication rate of the donor site and recipient site, and surgery time were recorded. Sequence analysis was conducted to determine the elements that have enabled to implement this technique reliably and effects of the learning curve. The series was split into two periods (1994/2011 and 2012/2014) corresponding to two different hospitals with the same team.
  
  
  RESULTS
  The total number of shreds of 1138 between November 1994 and December 2014 respectively with 477 and 661 the period 1994/2011 to 2012/2014 period. The failure rate increased from 8% to 2.2%.
  
  
  CONCLUSIONS
  The establishment of units mainly dedicated to microsurgical reconstruction can offer the DIEP technique reliably and reproducibly.
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. Electronic address: laurent.lantieri@egp.aphp.fr.
authors.forename: L
authors.initials: L
authors.lastname: Lantieri
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Hivelin
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: M D
authors.initials: MD
authors.lastname: Benjoar
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Quilichini
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Hutzinger
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Marchac
authors.affiliation: Service de chirurgie plastique, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Lepage
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D005602:France; D058752:Free Tissue Flaps; D006801:Humans; D059032:Learning Curve; D016462:Mammaplasty / Q000639:trends*; D008866:Microsurgery; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Autologous breast reconstruction; Breast cancer; Cancer du sein; DIEP; DIEP flap; Microchirurgie; Microsurgery; Reconstruction mammaire