Abstract

FONSECA PORTILLA, G.  and  VARGAS NARANJO, S.. Mammary reconstruction at the S. Juan de Dios Hospital, Costa Rica: a transversal study. Cir. plást. iberolatinoam. [online]. 2006, vol.32, n.2, pp.93-98. ISSN 1989-2055.

Mammary Reconstruction was introduced in the Hospital San Juan de Dios in the 80's for the demonstrated improvement in the quality of life of the mastectomized patient; by the moment we practise two surgical procedures: the Transversal Rectums Abdominal Muscle flap (TRAM) and the Dorsal muscle flap (DA). We made a traversal study to describe the experience of the Hospital San Juan de Dios in relation to this two main surgical procedures for mammary reconstruction. A sample of 110 clinical files was obtained with a standar error of the 5 % and a significance of 97%. We study variables such as age, complications, hospital stay and decision of symmetrical reconstruction of areola nipple and contralateral breast mammary. The average age of the patients was 49.2 years with a 8.8 year-old standard deviation. Complications and the surgical technique was carried out test of 2 lines (squared Chi) which was significant (p=0.003), therefore we discarded dependence between complications and surgical procedure. Hospital stay seems to be associated to surgery . The areola-nipple reconstruction and surgery for contralateral breast symmetry present a low frequency among the patients. The average age of the patients coincides with those described in other studies and with the age in that the appearance of mammary cancer is more frequent. There is not dependence between surgery type and the evaluated complications; nevertheless it is considered there are inherent complications to each technique. The low acceptance of surgery to get symmetry and reconstruction of the complex areola - nipple may be depends on these patients have sufered multiple surgeries and adjuvant treatments, so they are a little reluctant to other additional surgical procedures. The hospital stay can be associated to the surgical technique, since TRAM technique needs bigger cares than the DA one. As conclusion, TRAM and DA are two appropriate surgical options for mammary reconstruction; the election will depends on the patient's characteristics and on the surgeon's dealer. However in those patients who are candidate to both surgeries, TRAM should be the like first surgical election.

Keywords : Mammary reconstruction; TRAM flap; Dorsal flap.

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