Psychosocial and sexual well-being in breast cancer survivors undergoing immediate breast reconstruction: The mediating role of breast satisfaction.

OBJECTIVE: This study aimed to explore (1) the levels of quality of life (psychosocial, physical and sexual well-being) and breast satisfaction in breast cancer patients (BCP) after immediate reconstruction (IR), considering surgery reason and surgical technique, and (2) the explanatory and predictive capacity of psychosocial well-being on breast satisfaction, and of both on sexual well-being. METHODS: This prospective study included 36 BCP who underwent IR between June 2006 and December 2014. RESULTS: Highest levels of quality of life were found in psychosocial well-being and sexual well-being, with no statistically significant differences by surgery reason or surgical technique in any quality of life indicator or breast satisfaction. Psychosocial, physical well-being and breast satisfaction explained 56.16% of the variance in sexual well-being, where 44.67% was attributed to psychosocial well-being. In addition, breast satisfaction statistically significantly mediated the relationship between psychosocial and sexual well-being, independently of physical well-being. CONCLUSION: Our findings highlight the importance of IR in reducing psychological morbidity and preserving the quality of life and breast satisfaction. Furthermore, this research indicated that psychosocial well-being should be considered a useful personal resource for improving the sexual well-being of BCP undergoing IR both through its direct effect and the mediated effect of breast satisfaction.

Colecistectomía laparoscópica de puerto único en un programa de CMA / Single port laparoscopic cholecystectomy in major ambulatory surgery (MAS)

Introducción: La cirugía endoscópica por orificios naturales es una nueva modalidad quirúrgica en fase de desarrollo. La vía más natural para los cirujanos es usar una cicatriz ya existente como es el ombligo. La reciente introducción de trocares diseñados para este fin ha hecho posible su puesta en práctica. Material y métodos: En este estudio presentamos nuestra experiencia preliminar en la colecistectomía laparoscópica con puerto de acceso único umbilical, mediante un estudio prospectivo que incluye a 26 pacientes intervenidos entre enero 2009 y enero 2010. También pretendemos conocer su posible realización en régimen de CMA. Resultados: Todos los pacientes presentaban colelitiasis no complicadas, aunque en 5 se identifico una colecistitis en la cirugía. El tiempo quirúrgico promedio fue de 51,2min. La estancia hospitalaria media fue 25,7h. En el 76,92% de los pacientes el ingreso fue menor de 24h. No hubo ningún reingreso ni complicación intraoperatoria o postoperatoria importante. Conclusiones: A la vista de nuestros resultados la colecistectomía laparoscópica por puerto único favorece su inclusión en un programa de cirugía mayor ambulatoria (AU)

Introduction: Natural orifice endoscopic surgery is a new surgical procedure still in the development phase. The most natural entry for surgeons is to use an already existing scar, such as the navel. The recent introduction of trocars designed for this purpose has made it possible to put this into practice. Material and methods: We present our preliminary experience in single trans‐umbilical incision laparoscopic cholecystectomy, by means of a prospective study which included 26 patients operated on between January 2009 and January 2010. We also attempt to find out whether it can be performed in a MAS programme. Results: All patients had uncomplicated cholelithiasis, although in 5 of them cholecystitis was identified during the surgery. The mean surgical time was 51.2min. The mean hospital stay was 25.7h, and 76.92% of patients were admitted for less than 24h. There were no re-admissions or significant intra-operative or post-operative complications. Conclusions: On looking at our results, single port laparoscopic cholecystectomy could be included in a major ambulatory surgery programme (AU)