Surgeon-conducted color Doppler ultrasound deep inferior
epigastric artery perforator mapping: A cohort study and
learning curve assessment

J 2023

Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment

BAJUS, Adam, Tomáš KUBEK, Luboš DRAŽAN, Jiří VESELÝ, Adam NOVÁK et. al.

Basic information

Original name

Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment

Authors

BAJUS, Adam (203 Czech Republic, belonging to the institution), Tomáš KUBEK (203 Czech Republic, belonging to the institution), Luboš DRAŽAN (203 Czech Republic, belonging to the institution), Jiří VESELÝ (203 Czech Republic, belonging to the institution), Adam NOVÁK (203 Czech Republic, belonging to the institution), Andrej BERKEŠ (703 Slovakia, belonging to the institution) and Libor STREIT (203 Czech Republic, guarantor, belonging to the institution)

Edition

Journal of Plastic, Reconstructive & Aesthetic Surgery, OXFORD, ELSEVIER, 2023, 1748-6815

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.700 in 2022

RIV identification code

RIV/00216224:14110/23:00130355

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.bjps.2022.10.022

UT WoS

000988325300001

Keywords in English

DIEP flap perforator mapping; Learning curve; Color Doppler ultrasound; computed tomographic angiography

Abstract

V originále

Background Perforator mapping using diagnostic methods facilitates deep inferior epigastric perforator (DIEP) flap planning. Computed tomographic angiography (CTA) is a well-proven tool for perforator mapping. However, the benefits of color Doppler ultrasonography (CDU) are as follows: 1) CDU involves dynamic real-time examination and 2) does not use radiation. Comparing the accuracies of both methods in a cohort of patients, this study aimed to evaluate the learning curve of surgeon-conducted CDU perforator mapping. Methods Twenty patients undergoing DIEP flap breast reconstruction were enrolled in a cohort study. All patients underwent CTA perforator mapping preoperatively. XY coordinates of significant perforators were subtracted by a radiologist. A single surgeon (sonographer) with minimal experience with CDU performed CDU perforator mapping, including XY coordinates subtraction. The sonographer was blinded to the CTA data. The reference coordinates of dissected perforators were measured during surgery. Deviations from reference coordinates for both methods were compared, and CDU mapping learning curve was assessed using Joinpoint Regression. Results We included 20 women (32 DIEP flaps and 59 dissected perforators). The mean deviation between mapped and reference coordinates was 1.00 (0.50–1.12) cm for CDU and 0.71 (0.50–1.12) cm for CTA. The learning curve of CDU mapping showed the breaking point after the seventh patient (≈ 21 localized perforators). After the breaking point, no significant differences between the deviations of both methods were found (p = 0.980). Conclusion A limited number of examinations were needed for the surgeon to learn CDU DIEA perforator mapping with accuracy similar to that of CTA mapping.

Links

MUNI/A/1360/2022, interní kód MU

Name: Evaluace inovativních postupů plastické a rekonstrukční chirurgie III

Investor: Masaryk University, Evaluation of Innovative Procedures in Plastic and Reconstructive Surgery III

MUNI/A/1457/2021, interní kód MU

Name: Evaluace inovativních postupů plastické a rekonstrukční chirurgie II

Investor: Masaryk University

MUNI/A/1494/2019, interní kód MU

Name: Klinický přínos vizualizace cévního zásobení perforátorových laloků pomocí CT angiografie a duplexní sonografie

Investor: Masaryk University, Category A

MUNI/A/1668/2020, interní kód MU

Name: Evaluace inovativních postupů plastické a rekonstrukční chirurgie (Acronym: KPECH SV 2021)

Investor: Masaryk University

Citovat

BAJUS, Adam, Tomáš KUBEK, Luboš DRAŽAN, Jiří VESELÝ, Adam NOVÁK, Andrej BERKEŠ and Libor STREIT. Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment. Journal of Plastic, Reconstructive & Aesthetic Surgery. OXFORD: ELSEVIER, 2023, vol. 76, January 2023, p. 105-112. ISSN 1748-6815. Available from: https://dx.doi.org/10.1016/j.bjps.2022.10.022.

@article{2258319,
   author = {Bajus, Adam and Kubek, Tomáš and Dražan, Luboš and Veselý, Jiří and Novák, Adam and Berkeš, Andrej and Streit, Libor},
   article_location = {OXFORD},
   article_number = {January 2023},
   doi = {http://dx.doi.org/10.1016/j.bjps.2022.10.022},
   keywords = {DIEP flap perforator mapping; Learning curve; Color Doppler ultrasound; computed tomographic angiography},
   language = {eng},
   issn = {1748-6815},
   journal = {Journal of Plastic, Reconstructive & Aesthetic Surgery},
   title = {Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment},
   url = {https://www.sciencedirect.com/science/article/pii/S1748681522005630},
   volume = {76},
   year = {2023}
}

TY  - JOUR
ID  - 2258319
AU  - Bajus, Adam - Kubek, Tomáš - Dražan, Luboš - Veselý, Jiří - Novák, Adam - Berkeš, Andrej - Streit, Libor
PY  - 2023
TI  - Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment
JF  - Journal of Plastic, Reconstructive & Aesthetic Surgery
VL  - 76
IS  - January 2023
SP  - 105-112
EP  - 105-112
PB  - ELSEVIER
SN  - 17486815
KW  - DIEP flap perforator mapping
KW  - Learning curve
KW  - Color Doppler ultrasound
KW  - computed tomographic angiography
UR  - https://www.sciencedirect.com/science/article/pii/S1748681522005630
N2  - Background Perforator mapping using diagnostic methods facilitates deep inferior epigastric perforator (DIEP) flap planning. Computed tomographic angiography (CTA) is a well-proven tool for perforator mapping. However, the benefits of color Doppler ultrasonography (CDU) are as follows: 1) CDU involves dynamic real-time examination and 2) does not use radiation. Comparing the accuracies of both methods in a cohort of patients, this study aimed to evaluate the learning curve of surgeon-conducted CDU perforator mapping. Methods Twenty patients undergoing DIEP flap breast reconstruction were enrolled in a cohort study. All patients underwent CTA perforator mapping preoperatively. XY coordinates of significant perforators were subtracted by a radiologist. A single surgeon (sonographer) with minimal experience with CDU performed CDU perforator mapping, including XY coordinates subtraction. The sonographer was blinded to the CTA data. The reference coordinates of dissected perforators were measured during surgery. Deviations from reference coordinates for both methods were compared, and CDU mapping learning curve was assessed using Joinpoint Regression. Results We included 20 women (32 DIEP flaps and 59 dissected perforators). The mean deviation between mapped and reference coordinates was 1.00 (0.50–1.12) cm for CDU and 0.71 (0.50–1.12) cm for CTA. The learning curve of CDU mapping showed the breaking point after the seventh patient (≈ 21 localized perforators). After the breaking point, no significant differences between the deviations of both methods were found (p = 0.980). Conclusion A limited number of examinations were needed for the surgeon to learn CDU DIEA perforator mapping with accuracy similar to that of CTA mapping.
ER  -

BAJUS, Adam, Tomáš KUBEK, Luboš DRAŽAN, Jiří VESELÝ, Adam NOVÁK, Andrej BERKEŠ and Libor STREIT. Surgeon-conducted color Doppler ultrasound deep inferior epigastric artery perforator mapping: A cohort study and learning curve assessment. \textit{Journal of Plastic, Reconstructive \&{} Aesthetic Surgery}. OXFORD: ELSEVIER, 2023, vol.~76, January 2023, p.~105-112. ISSN~1748-6815. Available from: https://dx.doi.org/10.1016/j.bjps.2022.10.022.

Detailed Information on Publication Record