Ανατομικές παραλλαγές των διατιτραινόντων κλάδων των εν τω βάθει κάτω επιγάστριων αγγείων και η κλινική του σημασία
Λυμπερόπουλος Νικόλαος
(EL)
Background: The popularity of the DIEP flap has increased over the last decade.
However, there is little information regarding the transfusion rates of this
complex
procedure. The current study reports the transfusion rates in patients who
underwent
DIEP flap reconstruction in our unit with an attempt to correlate significant
blood loss
with potential predictors such as the abdominal flap weight.
Methods-Material: A retrospective review of 131 patients who underwent DIEP
reconstruction was performed. Patients’ characteristics, risk factors,
incidence of blood
transfusions, Hb drop and complications were reviewed. For statistical analysis
the
two-tailed Student t-test, chi-squared significance test and multiple
regression model
were used.
Results: 12 patients (9.1%) were transfused compared to 80.3% and 18.8%
described
in the literature. Definite association was found between the presence of a
complication
and transfusion. No correlation was found between age, obesity, chemotherapy
and/
or radiotherapy or tamoxifen treatment and blood loss. However, operation
duration,
complications and weight all found to have significant correlation. On average,
every
additional hour of surgery adds 0.25 grams of Hb drop; the presence of a
complication
adds 0.45 grams of Hb drop, and every extra gram of tissue removed from the
abdomen
adds an extra 0.001 gram of Hb drop.
Conclusion: The different transfusion rates published reflect variations in
surgical
strategies, different operative technical details but mostly transfusion
protocols applied
in each unit. As a correlation with complications was found, it is quite
important to
identify predictors for significant blood loss to optimise the operation
outcome which
in our study are additional time of surgery, the presence of complication and
increased
flap weight.
(EN)
