在DIEP片重建规划中,CT血管造影期间CT扫描分阶段的作用不断变化
Hazim Ahmed1, Iolo Thomas-Jones1, Zita M Jessop1
1Plastic surgery Department, North Bristol Trust, UK.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
|September 27, 2024
概括
在手术前的CT血管学 (CTA) 阶段测定深下腹膜穿孔器 (DIEP) 片乳房重建发现了许多患者的偶然发现. 修改了实践,为高风险病例保留分期,降低了成本,但没有错过癌症.
科学领域:
- 瘤外科手术是一项瘤外科手术.
- 放射学 放射学是一门学科.
- 整形和重建外科手术 整形和重建手术
背景情况:
- 术前CT血管造影 (CTA) 对于深下表胃穿孔器 (DIEP) 片乳房重建计划至关重要.
- 在手术前阶段的偶然发现可能会影响患者的管理.
- 实施和修改了一种结合CTA和CT分期协议.
研究的目的:
- 描述由CTA和CT相结合的分期协议产生的偶然发现的管理.
- 评估协议修改对患者管理和成本效益的影响.
主要方法:
- 对292名患者 (2015-2019年第一组) 和101名患者 (2019-2021年第二组) 进行DIEP重建的回顾性分析.
- 第二组协议修改:CT分期仅限于晚期重建的化疗患者.
- 两组人都接受了CT测试,包括胸部,腹部,骨盆和肌肉骨系统.
主要成果:
- 30%的第一组发现需要随访;实践改变为高风险分期.
- 在第二组中,56.4%的人有偶然的发现,42.1%需要重复扫描,7%的人转移到其他专业.
- 没有发现隐藏的转移性乳腺癌;在第一组中发现了1%的新发原发性癌症.
结论:
- 查无症状乳腺癌患者的CTA并非普遍实践或指导方针支持.
- 该部门停止了低风险患者的手术前分期,将其保留给高风险组以降低成本.
- 修改后的分期协议旨在优化资源配置,同时保持患者的安全.
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