Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Self-administered Follow-up Using a Low-sensitivity Pregnancy Test after Medical Abortion: Results of a Partially Randomized Patient Preference Trial.","authors":"Maren Janotta, Lena Rehfeld","doi":"10.1055/a-2735-4673","DOIUrl":"https://doi.org/10.1055/a-2735-4673","url":null,"abstract":"<p><strong>Introduction: </strong>In Germany, follow-up after medical abortion is typically conducted via ultrasound examination. International evidence suggests that self-administered follow-up using low-sensitivity pregnancy tests may be a safe and acceptable alternative. This study assessed the effectiveness and acceptability of this approach within the German healthcare system.</p><p><strong>Methods: </strong>In this prospective, multicenter, partially randomized, patient preference study conducted in 11 German centers (March-September 2024) involving 312 women, participants with strong preferences could choose their preferred follow-up method, while all others were randomized to either self-testing or ultrasound follow-up. Follow-up was performed using a low-sensitivity pregnancy test (1000 mIU/ml) at home or by ultrasound examination in the clinic. The primary outcome was the detection of ongoing pregnancies; patient satisfaction was assessed as a secondary outcome.</p><p><strong>Results: </strong>The detection rate of ongoing pregnancies was 100% in both groups. Specificity was 92.7% in the self-testing group and 100% in the ultrasound group. Complications were rare and occurred at similar rates in both groups. Discordant cases were rare and mainly represented false-positive results with faint test lines near the cut-off; severe complications did not occur more frequently. Satisfaction with the follow-up method was slightly lower in the self-testing group (85.9%) compared to the ultrasound group (98.3%) but remained within an acceptable range. Subjective feelings of safety were high in both groups.</p><p><strong>Conclusion: </strong>Self-administered follow-up using a low-sensitivity pregnancy test is a safe and well-accepted alternative to ultrasound examination after medical abortion. It may improve access to follow-up care, particularly for women living in underserved or remote areas.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 3","pages":"289-295"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on: Firsttrimester Diagnosis and Therapy @ 11 - 13 ⁺⁶ weeks' gestation : Amendment to the Guideline of DEGUM, ÖGUM, SGUMGG, DGGG, ÖGG, Gynecologie Suisse, DGPM, DGPGM, BVF, ACHSE (AWMF S2e LL085-002 1.1.2024) (https://register.awmf.org/de/leitlinien/detail/085-002).","authors":"Constantin S von Kaisenberg, Peter Kozlowski, Karl O Kagan, Markus Hoopmann, Kai-Sven Heling, Rabih Chaoui, Philipp Klaritsch, Barbara Pertl, Tilo Burkhardt, Sevgi Tercanli, Jochen Frenzel, Christine Mundlos","doi":"10.1055/a-2721-9742","DOIUrl":"10.1055/a-2721-9742","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 12","pages":"1291-1303"},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GDM screening & intervention @ 11 - 13 ⁺⁶ instead of 24 - 28 weeks' gestation: time for a change in paradigm?","authors":"Constantin von Kaisenberg","doi":"10.1055/a-2721-9792","DOIUrl":"10.1055/a-2721-9792","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 12","pages":"1288-1290"},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Pathogenic Germline Variants in BRCA and Non-Breast/Non-Ovarian Cancer Types in the German Population.","authors":"Nicole Zilski, Robert Roehle, Stephanie Stegen, Jens Uwe Blohmer, Jenny Katharina Wagner, Dorothee Speiser","doi":"10.1055/a-2737-2046","DOIUrl":"10.1055/a-2737-2046","url":null,"abstract":"<p><strong>Introduction: </strong>Families with pathogenic germline variants (pv) in BRCA1/2 may have besides breast and ovarian cancer an elevated lifetime risk for other cancer types.</p><p><strong>Material and methods: </strong>Data and pedigree information from 1852 family members of 286 BRCA1/2 positive families were analyzed. Genetic testing was conducted between 2015 and 2017 at the HBOC center at Charité - Universitätsmedizin Berlin. Relative cancer risk (RR) was calculated by comparing observed cancer incidence with the expected incidence in the German population.</p><p><strong>Results: </strong>BRCA1/2 positive families showed an elevated cancer risk for gastric and cervical cancer regardless of BRCA status. The relative risk of gastric cancer was higher in BRCA2 carriers compared to BRCA1 carriers (gBRCA1 RR 1.42; 95% CI: 0.65-2.69 vs. gBRCA2 RR 1.88; 95% CI: 0.75-3.87). Similarly, the relative risk for cervical cancer was also greater in BRCA2 carriers than in BRCA1 carriers (gBRCA1 RR 1.88; 95% CI: 0.69-4.09 vs. gBRCA2 RR 2.09; 95% CI: 0.56-5.35). Additionally, BRCA2 families showed an increased risk of pancreatic cancer (RR 1.56; 95% CI, 0.50 to 3.63). No significant associations were found for other cancer entities.</p><p><strong>Conclusion: </strong>In the present study, an increased risk of gastrointestinal cancer was observed in German families with pathogenic BRCA1/2 variants, consistent with findings from previous research. Potential new associations with cervical cancer were also identified, warranting confirmation through large prospective studies. These findings highlight the importance of developing additional screening programs or preventive strategies for BRCA carriers, especially with regard to upper gastrointestinal tract malignancies.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 1","pages":"56-64"},"PeriodicalIF":1.9,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Questionnaire for the Structured Assessment of the Use of Complementary Medicine Methods and Procedures in Patients from the S3 Guideline Complementary Medicine in Oncology and Practical Use of it in Patients with Gynecological Cancer.","authors":"Katharina Seitz, Anna-Katharin Theuser, Carolin C Hack, Peter A Fasching, Julius Emons, Lena Brückner, Katharina Au, Matthias W Beckmann, Milena Beierlein","doi":"10.1055/a-2717-7656","DOIUrl":"10.1055/a-2717-7656","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;For the first time, an S3 guideline on complementary medicine in oncology was published in 2021, 2024 in May version 2.0 was published. The broad spectrum of complementary and integrative medicine was presented at the highest level of evidence, the respective established interventions were comprehensively addressed, and recommendations were made in the case of sufficient data availability. The guideline also contains a questionnaire for a risk-adapted evaluation of utilized CIM (complementary and integrative medicine) interventions. In this article, the clinical validation of this questionnaire from the guideline is carried out, as well as a descriptive analysis of utilization of CIM interventions in a cohort with gynecologial cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The present study is a cross-sectional study conducted at the Women's Hospital of the University Hospital Erlangen. In a first stage, rolled out from January to February 2022, fifty patients completed the questionnaire for the structured assessment of the use of complementary medicine from the S3 guideline \"Complementary Medicine in Oncology\", as well as a validation questionnaire. The latter included the comprehensibility of the questions, the time taken to complete them, as well as any problems encountered and suggestions for improvement. After successful validation of the questionnaire, in the second phase, patients with gynecologic cancer were invited to participate in the survey.The patient population was characterized by descriptive analyses of age, educational level, lifestyle factors such as dietary habits and physical activity, as well as tumor characteristics and treatment. In addition, the frequency of complaints and the utilization of complementary interventions and procedures, classified according to their risk of interactions, were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Validation showed that forty-five out of fifty (90%) patients felt that the questionnaire was clear to understand. Forty-seven (94%) of respondents indicated that the time taken to answer the questions was reasonable. In figures, 42% needed less than five minutes and 48% less than ten minutes.When looking at the utilization of CIM in patients with gynecological tumors, most participants were suffering from ovarian cancer (n = 61, 41.8%), followed by endometrial cancer (n = 33, 22.6%), cervical cancer (n = 32, 21.9%) and vulvar cancer (n = 20, 13.7%). In total, the utilization of a CIM intervention was described 267 times. According to the traffic light classification system in the guideline questionnaire the interventions of the green category (low risk for interaction) (n = 124, 46.4%) was the most commonly used. Therapies in the yellow category were used slightly less frequently (n = 93, 34.8%). CIM interventions of the red category were mentioned 50 times (18.7%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and discussion: &lt;/strong&gt;To date, there has been a lack of standardized surveys ","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 1","pages":"35-44"},"PeriodicalIF":1.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How We Can Optimize Dysmenorrhea Treatment: Real-World Results from a Cross-Sectional, Multi-Center Study.","authors":"Christoph Cirkel, Hartmut Göbel, Carl Göbel, Ibrahim Alkatout, Norbert Brüggemann, Antonia Katharina Kaiser, Jens Minnerup, Achim Rody, Anna Cirkel","doi":"10.1055/a-2715-0626","DOIUrl":"10.1055/a-2715-0626","url":null,"abstract":"<p><strong>Introduction: </strong>Dysmenorrhea is a common and disabling condition in women. We investigate the prevalence of endocrine dysmenorrhea treatment (EDT) and the use of pain medication in dysmenorrhea patients without surgically treated endometriosis (no-STE).</p><p><strong>Material and methods: </strong>Patients were recruited for a cross-sectional multicenter study from two German university hospital endometriosis centers. Additional participants were enrolled with support of the German Endometriosis Association. A total of 821 premenopausal women with dysmenorrhea were examined. 266 had no STE, 42 of whom underwent surgery.</p><p><strong>Results: </strong>The study aimed to assess real-world treatment patterns for dysmenorrhea in women without surgically treated endometriosis. Only 35.7% of the no-STE patients (n = 95) were currently receiving EDT and 241 (90.6%) were taking pain medication for dysmenorrhea. Menstrual pain remained high even under pain medication (5.06 [95% CI 4.58-5.55] visual analogue scale [VAS] vs. 4.63 [95% CI 4.29-4.98] in patients with and without EDT; F = 2.073 p > 0.05). 149 (87.1%) of the patients who did not take EDT also did not undergo surgery for diagnosis and treatment of dysmenorrhea. Combined oral contraceptives as EDT were utilized cyclically by 14 (14.7% of EDT users) and in an extended/continuous use by 27 patients (28.4% of EDT users). Long term intake of progestin only preparations was utilized by 38 patients (40% of EDT users). The reasons for refusing EDT were analyzed in detail.</p><p><strong>Conclusion: </strong>Many patients refuse to undergo long-term EDT. The reasons for refusal are often not in line with current guidelines. Clinicians should better inform their patients about the advantages and disadvantages of EDT and surgery in the diagnosis and treatment of endometriosis related symptoms.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 2","pages":"208-217"},"PeriodicalIF":1.9,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146179004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mistreatment and Discrimination during Childbirth, Associations with Symptoms of Childbirth-Related Posttraumatic Stress Disorder and the Mediating Role of the Subjective Birth Experience: A Quantitative Analysis Within the Prospective Cohort Study RESPECT _PARENTS.","authors":"Christin Porstendorfer-Almeida Froz, Bianka Vollert, Ionna Hansen, Nina Schurig, Lara Seefeld, Victoria Weise, Cahit Birdir, Pauline Wimberger, Susan Garthus-Niegel","doi":"10.1055/a-2717-7798","DOIUrl":"10.1055/a-2717-7798","url":null,"abstract":"<p><strong>Background: </strong>Mistreatment and discrimination during childbirth are a global public health concern. Such experiences can adversely affect the subjective birth experience and increase the likelihood of compromised postpartum mental health, including symptoms of childbirth-related posttraumatic stress disorder (CB-PTSD) not only in mothers/birthing parents, but also in partners. This study examines instances of mistreatment and discrimination during childbirth, their association with CB-PTSD symptoms, and the potential mediating role of the subjective birth experience in both parents.</p><p><strong>Methods: </strong>Data were retrieved from the prospective RESPECT _PARENTS cohort, a German community sample. For the current study, data from n = 1075 mothers/birthing parents and n = 454 partners, collected at two assessment points, i.e., during pregnancy and eight weeks after birth, were included. Regression and mediation models were used to analyze the associations separately for mothers/birthing parents and partners.</p><p><strong>Results: </strong>Mistreatment during childbirth was reported by 25.8% of mothers/birthing parents and 6.8% of partners, whereas perceived discrimination was reported by 3.9% of mothers/birthing parents and 3.5% of partners. These experiences predicted more severe CB-PTSD symptoms among mothers/birthing parents. For both parents, experiencing more mistreatment and more discrimination was associated with a more negative subjective birth experience, which in turn was associated with more severe CB-PTSD symptoms, demonstrating a significant mediation effect.</p><p><strong>Conclusion: </strong>The current study indicates that mistreatment and discrimination during childbirth exist in Germany among both mothers/birthing parents and partners, potentially contributing to a more negative subjective birth experience and more severe CB-PTSD symptoms. The findings emphasize the need to address mistreatment and discrimination during childbirth for both parents, in general and as potential risk factors for adverse outcomes.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 12","pages":"1304-1325"},"PeriodicalIF":1.9,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction of Labor with Oral Misoprostol - Effectiveness and Safety of Low-dose vs. High-dose Regimens.","authors":"Asal Fathi Roodsari, Friederike Gebauer, Lars Brodowski, Vivien Less, Philipp Sibbertsen, Peter Hillemanns, Constantin Sylvius von Kaisenberg, Rüdiger Klapdor, Vivien Dütemeyer","doi":"10.1055/a-2713-8946","DOIUrl":"10.1055/a-2713-8946","url":null,"abstract":"<p><strong>Background: </strong>Before the market launch of low-dose misoprostol (LDM) in the form of 25 µg tablets, high-dose misoprostol (HDM) was used off-label for labor induction in Germany. The differences between the effectiveness and safety of both dosage forms were investigated.</p><p><strong>Method: </strong>This retrospective cohort study included all pregnant women who were induced with misoprostol between 2019 and 2023. Until September 2021, misoprostol was available in the form of a 200 µg tablet which was divided manually and administered orally at an initial dose of 50 µg, followed by 100 µg every four hours. This was compared with the current administration regimen of an initial dose of 25 µg followed by 50 µg in terms of vaginal birth rate, duration of induction, and maternal and neonatal outcomes.</p><p><strong>Results: </strong>A total of 1941 patients were analyzed; 1397 received HDM and 544 received LDM. Vaginal delivery was achieved with equal frequency (87% HDM vs. 88% LDM, p = 0.95). The duration of induction was shorter in the HDM group (20.7 hours vs. LDM 22.7 hours, p = 0.028), and opioid requirements were higher (HDM 74% vs. LDM 69%, p = 0.036). Maternal complications and neonatal outcomes did not differ. Regression analysis found that high BMI was an independent factor for a failed first induction attempt (B 0.002, SEM 0.0004, p < 0.001).</p><p><strong>Conclusion: </strong>Both dosing regimens achieved high vaginal birth rates with comparable safety. Inductions with HDM were two hours shorter but were associated with higher opioid use.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 12","pages":"1326-1333"},"PeriodicalIF":1.9,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Toxicity of Endocrine-based Oral CDK4/6 Inhibitor Therapies.","authors":"Henning Schäffler, Sabine Heublein, Julia Lichtblau, Lisa Wisniewski, Brigitte Rack, Wolfgang Janni, Alexander Englisch, Johannes Englisch, Tobias Engler, Andreas Hartkopf, Sara Brucker, Lisbeth Hilmer, Franziska Fick, Fabian Kohls, Maggie Banys-Paluchowski, Achim Rody, Dominik Dannehl, Nikolas Tauber","doi":"10.1055/a-2717-7930","DOIUrl":"10.1055/a-2717-7930","url":null,"abstract":"<p><p>Adjuvant endocrine therapy with CDK4/6 inhibitors necessitates regular visits, lab assessments and side effect management, currently conducted primarily at breast cancer centers in Germany. This retrospective analysis estimates the potential travel distances, times and CO ₂ emissions associated with centralized therapy management of adjuvant CDK 4/6 inhibitor application. Eligible patients for ribociclib or abemaciclib therapy were retrospectively identified from 5053 early breast cancer cases at the university hospitals of Ulm, Lübeck and Tübingen, using the monarchE and NATALEE criteria. Travel times were calculated assuming 24 visits over three years for ribociclib and 18 visits over two years for abemaciclib. Of the HR+/HER2- cohort, 1432 (38%) were potentially eligible for adjuvant CDK4/6 inhibitors, with 1080 patients included, based on available postal codes. Median travel distances and times for Ribociclib (3 years) were 1200 km (24.0 hours driving; 176.0 kg CO ₂ emissions; 50.4 hours by public transport; 72.0 kg CO ₂ emissions) and 900 km (18.0 hours driving; 132.3 kg CO ₂ emissions; 37.8 hours by public transport; 54.0 kg CO ₂ emissions) for abemaciclib (2 years). Despite its retrospective limitations, this analysis provides valuable insight into the impact of centralized care on travel time and CO ₂ emissions for oral cancer therapies in Germany. As the use of oral therapies increases, clinicians, patients, policymakers and the pharmaceutical industry should jointly develop strategies to optimize the safety, feasibility, and efficacy of oral therapies.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 1","pages":"65-74"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Perforator Flaps in Oncoplastic Breast Surgery: Clinical Applications of ICAP and TDAP Flaps in Reconstruction and Complication Management.","authors":"Georg Schmidt, Theresa Mayo, Angela von Falkenhausen, Marion Kiechle, Daniel Müller","doi":"10.1055/a-2708-5818","DOIUrl":"10.1055/a-2708-5818","url":null,"abstract":"<p><strong>Introduction: </strong>Local perforator flaps have become an increasingly important option in oncoplastic breast surgery. Despite their long-standing use, their application in clinical practice remains limited. This study evaluates the use of thoracic wall perforator flaps, specifically the intercostal artery perforator (ICAP) and thoracodorsal artery perforator (TDAP) flaps, for volume and skin replacement after breast-conserving therapy and in the management of complications following reconstructive procedures.</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis of 50 patients treated with local perforator flaps between March 2022 and March 2025 at the Interdisciplinary Breast Center, Klinikum rechts der Isar. Follow-up examinations were conducted in a standardized manner by the primary surgeon and included clinical and ultrasound assessments of the flap, as well as documentation of complications, perfusion, and patient-reported outcomes.</p><p><strong>Results: </strong>ICAP flaps were used in 39 cases and TDAP flaps in 11 cases. The majority of reconstructions (72%) were immediate. ICAP flaps were mainly used for lower and central defects, whereas TDAP flaps were used for upper outer quadrant and complex cases. The mean operative time was 109 minutes, longer for TDAP flaps (153 minutes). There was no total flap loss and complications were rare (one partial necrosis, three seromas). Radiotherapy was administered in 72% of cases without flap compromise. Flaps were also effective in the management of implant-related or autologous reconstruction complications.</p><p><strong>Discussion: </strong>Perforator flaps offer reliable, low morbidity reconstruction options with good aesthetic outcomes and low complication rates, even after radiotherapy. They are also suitable for secondary reconstruction and management of complications.</p><p><strong>Conclusion: </strong>Local perforator flaps, particularly ICAP and TDAP, are safe, versatile tools in oncoplastic breast surgery and should be more widely considered in clinical practice.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"86 1","pages":"45-55"},"PeriodicalIF":1.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}