Breast Reconstruction, Respiratory Function
Conditions
Keywords
Serratus Anterior, Accessory Respiratory, Tissue Expander, Respiratory Function Tests
Brief summary
This study evaluates the effect of breast reconstruction surgery on respiratory functions. 45 patients elected for unilateral or bilateral breast reconstruction surgery will go through respiratory function examinations a month prior to the surgery, one month after surgery and three months after surgery.
Detailed description
Breast reconstruction surgery using tissue expander and implant technique is the most common breast reconstruction surgery. During this procedure, the surgeon will insert a silicone expander under the Pectoralis Major muscle. In order to fully cover the expander, the surgeon will detach the Serratus Anterior \[SA\] muscle from its natural attachments in the rib cage and will attach the free edges to the lateral edge of the Pectoralis Major muscle. After the wound is healed, a gradual inflation of the expander with a physiological fluid will be done by injecting the fluid into a subcutaneous filling port connected to the expander by silicone tubing. When the tissues around the expander will reach the required size, the tissue expander can be replaced by a permanent silicone implant. The SA attachments are to the superior angle, medial border and inferior angle of the scapula and to the first to eighth ribs. Its main functions are stabilization and protraction of the scapula and turning the glenoid cavity superiorly in abduction of arms. In addition, the SA is an accessory respiratory muscle: when the scapula is stabilized, its contraction will lift the rib cage in order to help breathing. The importance of the SA in breathing has been examined since the late 19th century and until this day it is not fully agreed upon. Most studies agree that the SA major role in breathing is in deep breaths and is that the muscle is most effective for this purpose when arms are lifted. Since breast reconstruction procedure includes detachment of the SA from the rib cage and there by canceling its respiratory function, an examination of the respiratory functions before and after the procedure is in order to determine whether or not the overall respiratory functions had been effected. 45 patients elected for unilateral or bilateral breast reconstruction surgery will go through respiratory function examinations a month prior to the surgery, one month after surgery and three months after surgery. The examinations will include the following tests: Spirometry: FVC, FEV1, MVV. Lung capacities: FRC, RV, TLC. Breathing muscle strength: MIP, MEP.
Interventions
PROCEDURErespiratory function tests
FVC, FEV1, MVV, FRC, RV, TLC, MIP, MEP
Sponsors
Yaron Har-Shai
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* all subjects were elected for a unilateral or bilateral breast reconstruction using tissue expander by the Oncoplastic Committee of the plastic surgery unit in Carmel Medical Center. * all subjects agrees to enroll in research
Exclusion criteria
* subject is in a mental or physical condition that does not allow her to go through respiratory function tests. * subject was found with a respiratory disfunction or disease in the first respiratory function tests.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Forced vital capacity -FVC | a month prior to surgery | Forced vital capacity: the determination of the vital capacity from a maximally forced expiratory effort |
| Forced expiratory volume at one second -FEV1 | a month prior to surgery | Volume that has been exhaled at the end of the first second of forced expiration |
| Maximum voluntary ventilation-MVV | a month prior to surgery | Maximal voluntary ventilation: volume of air expired in a specified period during repetitive maximal effort |
| Functional residual capacity-FRC | a month prior to surgery | Functional residual capacity: the volume in the lungs at the end-expiratory position |
| Residual volume -RV | a month prior to surgery. | Residual volume: the volume of air remaining in the lungs after a maximal exhalation. |
| Total lung capacity-TLC | a month prior to surgery. | Total lung capacity: the volume in the lungs at maximal inflation, the sum of VC and RV. |
| Maximal inspiratory pressure-MIP | a month prior to surgery. | Maximal inspiratory pressure (MIP) is the maximal pressure that can be produced by the patient trying to inhale through a blocked mouthpiece |
| Maximal expiratory pressure-MEP | a month prior to surgery. | Maximal expiratory pressure (MEP) is the maximal pressure measured during forced expiration (with cheeks bulging) through a blocked mouthpiece after a full inhalation. |
Countries
Israel
Contacts
Primary ContactYaron Har-Shai, Proffesor
Backup ContactRaviv Allon
Outcome results
None listed