Kvaliteta reinervacije dojke nakon rekonstrukcije slobodnim režnjevima

master's thesis

• Title (english): Quality of reinnervation of the breast after free flap reconstruction
• Author: Filip Grladinović
• Mentor: Krešimir Bulić (mentor)
• Committee member: Davor Mijatović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Krešimir Bulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Rekonstrukcija dojke danas čini jednu od glavnih sastavnica liječenja karcinoma dojke. Svrha je vraćanje prirodnog oblika dojke koji kasnije povoljno utječe na kvalitetu života pacijentice. Rekonstrukcija režnjevima vlastitog tkiva danas predstavlja “zlatni standard” u rekonstrukciji dojke. Osim povoljnog estetskog rezultata otkriveno je da je moguće postići gotovo normalan osjet u rekonstruiranoj dojci što također pozitivno utječe na pacijenticu. Reinervacija je moguća spontanim urastanjem živaca ili mikrokirurškim spajanjem. Svrha ovog rada bila je kroz relevantnije studije procijeniti kvalitetu reinervacije dojke nakon rekonstrukcije slobodnim režnjevima. Istraživanja su pokazala da je oporavak osjeta varijabilan i relativno nepredvidiv, ovisno o metodi procjene i vremenu njezine primjene. Usprkos navedenoj heterogenosti dosadašnjih studija, vidljivo je kako režnjevi inervirani kirurškom koaptacijom živaca dovode do povoljnijih ishoda u usporedbi s neinerviranim, što se očituje ranijom pojavom i postupnim oporavkom osjeta s većom šansom za konačni povratak na razinu prije mastektomije. Zbog nedostatka standardizacije testova za objektivnu procjenu oporavka osjeta dojke nakon rekonstrukcije, ova problematika još uvijek nije razriješena te su potrebne veće studije koje bi mogle jasnije pokazati važnost reinervacije kao i razlike u kvaliteti reinervacije nakon rekonstrukcije različitim slobodnim režnjevima.

Abstract (english)

Breast reconstruction is one of the main components of breast cancer treatment. Its purpose is to restore the natural shape of the breast, which has a positive effect on the patient’s quality of life. Reconstruction using flaps of own tissue today represents the "gold standard" in breast reconstruction. In addition to a favorable aesthetic result, it was discovered that it is possible to achieve almost normal sensation in the reconstructed breast which also has an positive impact on the patient. Reinnervation is possible by spontaneous nerve ingrowth or microsurgical reattachment. The purpose of this paper was to evaluate the quality of breast reinnervation after free flap reconstruction by examining relevant studies. Research has shown that sensory recovery is variable and relatively unpredictable, due the diversity of the assessment methods and the time of their application. Despite the aforementioned heterogeneity of previous studies, it was shown that flaps innervated by surgical coaptation of nerves lead to more favorable outcomes compared to non-innervated ones, which manifests in earlier onset and gradual recovery of sensation with a greater chance of final return to pre-mastectomy level. Due to the lack of standardization of tests for objective assessment of breast sensation recovery after reconstruction, this issue is still unresolved. Larger studies, which could highlight the importance of reinnervation as well as differences in quality of reinnervation after reconstruction with different free flaps, are needed.

• Keywords: reinervacija; oporavak osjeta; rekonstrukcija dojke; slobodni režanj
• Keywords (english): reinnervation; sensation recovery; breast reconstruction; free flap
• Language: croatian
• URN:NBN: urn:nbn:hr:105:104996
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-03 13:11:00