Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Preoperative evaluation of tiny blood vessels is critical in flap surgery to improve safety and postoperative outcomes. This study assessed the efficacy of Viewtify, a 3-dimensional computer graphics (3DCG) software, in evaluating vascular pedicle and perforator locations in free flap surgery. METHODS: This retrospective study included 30 patients who underwent reconstructive surgery with a deep inferior epigastric artery perforator, profunda artery perforator, or fibular flaps between January 2021 and July 2024. The thickness of adipose tissue was measured using contrast-enhanced computed tomography at the flap harvest sites. Perforator visibility scores were assigned based on 3D reconstructed images from Viewtify, and correlations with patient factors (age, body mass index, and adipose thickness) were analyzed. RESULTS: Vascular pedicle was successfully identified in all patients. The perforator visibility was higher in the abdomen (4.9 ± 0.16) and thigh (4.6 ± 0.42) than in the lower leg (3.1 ± 0.90) (P < 0.05). A significant positive correlation was found between adipose thickness and the perforator visibility score (r = 0.533, P = 0.0025); however, no significant correlations with other factors were observed. CONCLUSIONS: Viewtify is an effective method for visualizing tiny blood vessels during preoperative planning, particularly in areas with thicker adipose tissue. Its use may improve surgical safety and precision, particularly in flap surgery involving abdominal and thigh regions. Further studies are required to optimize the imaging protocols for areas with thinner adipose tissue, such as the lower legs.

DOI： 10.1097/GOX.0000000000007119

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Immediate breast reconstruction (IBR) has become increasingly recognized in Japan as an important component of breast cancer care, improving patients' quality of life after mastectomy. While the adoption of IBR is growing, the reconstruction rate in Japan remains lower than in Western countries. To clarify the current practice and challenges, the Japanese Breast Cancer Society (JBCS) conducted a nationwide survey. METHODS: We conducted a comprehensive web-based questionnaire survey among all JBCS-certified institutions between December 2020 and February 2021. The survey assessed institutional capabilities, surgical techniques, decision-making criteria for BR, and the integration of adjuvant therapy. RESULTS: A total of 429 institutions responded, with 72.5% offering BR and 61.7% capable of providing immediate reconstruction. Nipple-sparing mastectomy (NSM) was performed at 73.7% of institutions offering reconstruction. Multidisciplinary conferences with plastic surgeons were held at 70.5% of institutions. Approximately 30% of institutions discontinued IBR if sentinel lymph node metastases were detected intraoperatively, and 62.8% avoided recommending IBR for patients likely to require postoperative radiation therapy. In 94% of institutions, BR did not cause delays in the administration of adjuvant chemotherapy. However, 15% of institutions modified their radiation therapy approach in reconstructed patients. Additionally, 27% of physicians still believed that BR could negatively affect prognosis. CONCLUSIONS: The survey confirmed that IBR is widely performed and feasible in Japan. However, institutional differences, limited access to plastic surgeons, and persistent misconceptions remain significant barriers. Strengthening multidisciplinary collaboration and establishing standardized guidelines will help improve BR rates and patient outcomes in Japan.

DOI： 10.1007/s12282-025-01723-5

PubMed

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Authorship：Lead author  

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Language：Japanese   Publisher：(一社)日本外科学会  

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Language：Japanese   Publisher：(一社)日本外科学会  

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Language：Japanese   Publisher：(一社)日本形成外科学会  

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Authorship：Lead author  

DOI： 10.15106/j_geka86_553

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