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Abstract：
Background The deep inferior epigastric perforator (DIEP) and latissimus dorsi (LD) flaps are two widely used autologous breast reconstructions. Despite studies on flap-volume changes, the time of the first measurement is not immediately after surgery. Therefore, this study aimed to investigate the change in volume over time from the immediate postoperative period using a three-dimensional (3D) scanner. Methods Patients who underwent breast reconstruction with a DIEP or LD flap between October 2019 and December 2020 at Showa University Koto Toyosu Hospital were included. The Kinect 3D scanner was used to measure the reconstructed and healthy breast volumes immediately after surgery and at 1, 3, 6, and 12 months. The control group was the healthy side, and the volumes obtained at each time point and ratios (to the immediate postoperative period) were calculated and analyzed using a linear mixed model. Results Of the 25 patients and 26 breasts examined, the postoperative increase in volume ratios was statistically significant in the DIEP flap group, except for the sixth month, but decreased significantly in the LD group. Compared with the control group, the volume ratio was significantly higher up to 3 months in the DIEP flap group and decreased significantly after 3 months in the LD flap group. Conclusions The volume of the LD flap continued to decrease immediately after surgery, whereas the volume of the DIEP flap increased by 10% up to 1M. Therefore, this increase in volume should be taken into consideration in studies where the initial measurements were not taken immediately after surgery.
摘要：
背景深腹壁下穿支（DIEP）和背阔肌（LD）皮瓣是两种广泛使用的自体乳房重建术。尽管有关于皮瓣体积变化的研究，第一次测量的时间不是在手术后立即进行的。因此,这项研究旨在使用三维（3D）扫描仪调查从术后即刻开始的体积随时间的变化。方法纳入2019年10月至2020年12月在昭和大学KotoToyosu医院接受DIEP或LD皮瓣乳房再造的患者。Kinect3D扫描仪用于在手术后立即以及1、3、6和12个月测量重建和健康的乳房体积。对照组为健康方，并使用线性混合模型计算和分析在每个时间点获得的体积和比率(与术后即刻)。结果在25例患者和26例乳房检查中，DIEP皮瓣组术后体积比增加有统计学意义,除了第六个月，但LD组明显下降。与对照组相比,DIEP皮瓣组3个月后体积比显著增高，LD皮瓣组3个月后显著下降。结论LD皮瓣术后即刻体积持续减小,而DIEP皮瓣的体积增加了10%，达到1M。因此,在未在手术后立即进行初始测量的研究中,应考虑到体积的增加.
