Anglia Ruskin Research Online (ARRO)
Browse
Ngaage_et_al_2018.pdf (944.12 kB)

The effect of CT angiography and venous couplers on surgery duration in microvascular breast reconstruction: a single operator’s experience

Download (944.12 kB)
journal contribution
posted on 2023-07-26, 15:00 authored by Ledibabari M. Ngaage, Georgette Oni, Bruno Di Pace, Raed R. Hamed, Laura J. Fopp, Brendan C. Koo, Charles M. Malata
Background: The use of CT angiography (CTA) or venous couplers (VCs) has led to shorter operative times in free flap breast reconstruction (FFBR). However, there are no reports on the effect of these two interventions relative to each other or combined. Methods: Abdominal based FFBRs performed by a single surgeon before introduction of either intervention were compared to those with VC only, and those after the addition of CTA to VCs (CT-VC). Operative time was defined as from “knife-to-skin” to insertion of the last stitch. Results: One hundred and twenty patients; 40 without intervention (WI), 40 with VC, and 40 with CT-VC. Introduction of VCs did not significantly reduce operative time compared to WI (P=0.73). However, patients in the CT-VC group had significantly shorter operations vs. WI (472 vs. 586 min, P<0.00001) and vs. VC alone (472 vs. 572 min, P=0.0006). Similarly, introduction of each intervention showed a stepwise decrease in ischaemia time (WI vs. VC: 100 vs. 89 min, P=0.0106; VC vs. CT-VC: 89 vs. 80 min, P=0.0307; WI vs. CT-VC: 100 vs. 80 min, P<0.00001). Conclusions: Combination of CTA and VC significantly reduced operative and ischaemic times for FFBR; this was predominantly due to use of CTA. CTA mitigates the surgical learning curve as demonstrated by shorter operating times via providing a vascular anatomy roadmap, thus facilitating flap harvest.

History

Refereed

  • Yes

Volume

7

Issue number

5

Page range

440-448

Publication title

Gland Surgery

ISSN

2227-684X

Publisher

Society for Translational Medicine

File version

  • Published version

Language

  • eng

Legacy posted date

2020-05-26

Legacy creation date

2020-05-26

Legacy Faculty/School/Department

Faculty of Health, Education, Medicine & Social Care

Usage metrics

    ARU Outputs

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC