Early postoperative complications of breast reconstruction by history of radiotherapy and reconstruction approach

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.

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RISK FACTORS OF COMPLICATIONS IN RECONSTRUCTIVE OPERATIONS AFTER HARTMANN PROCEDURE

Koloproktologia ◽

10.33878/2073-7556-2016-0-3-37-42 ◽

2016 ◽

pp. 37-42

Author(s):

V. I. Pomazkin

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Univariate Analysis ◽

Multivariable Analysis ◽

Hartmann Procedure ◽

Septic Complications ◽

Early Postoperative Complications ◽

Reconstructive Operations ◽

History Of ◽

Bowel Continuity

The aim of this work was to analyze early postoperative complications after restoration of bowel continuity in patients which undergone Hartmann procedure for tumor intestinal obstruction and to identify risk factors of complications. 192 patients were included in retrospective study. Early postoperative complications occurred in 18 (9,4%) patients. Univariate analysis showed that COPD increased the risk of complications in 1,7 times (p=0,044), history of septic complications at the previous surgery - in 4,3 times (p=0,011), the third grade of severity of intraperitoneal adhesions in comparison with the 1st grade - in 9,7 times (p=0,001). Multivariable analysis showed that the hazard ratio in patients with complications during the first operation was 4,3 (CI 1,7-23,3, p=0,021), and in patients with the 3d degree of adhesions of 7,5 (CI 1,3 to 15,6, p=0,001).

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Age and Overweight Are Not Contraindications for a Breast Reconstruction with a TMG-Flap—A Risk and Complication Analysis of a Retrospective Double Center Study Including 300 Patients

Journal of Clinical Medicine ◽

10.3390/jcm10050926 ◽

2021 ◽

Vol 10 (5) ◽

pp. 926

Author(s):

Karl Schwaiger ◽

Laurenz Weitgasser ◽

Maximilian Mahrhofer ◽

Kathrin Bachleitner ◽

Selim Abed ◽

...

Keyword(s):

Statistical Analysis ◽

Postoperative Complications ◽

Breast Reconstruction ◽

Data Extraction ◽

Free Flaps ◽

Risk Groups ◽

The Elderly ◽

Demographic Development ◽

Autologous Breast Reconstruction ◽

Significant Difference

Introduction: The transverse myocutaneous gracilis (TMG) flap has become a popular and reliable alternative for autologous breast reconstruction. Initially described as a valuable tissue source for women with low body-mass index, indications nowadays have widely expanded. The Western civilization demographic development with its aging population and the steady growing average BMI has led to increasing breast reconstructions with TMG flaps in overweight and aged individuals. Patients and Methods: A total of 300 TMG free flaps for unilateral autologous breast reconstruction were evaluated in the form of a retrospective double center cohort study. Data extraction, study group formation and statistical analysis (One-way analysis of variance (ANOVA), Pearson’s chi-squared statistical analysis and relative risk calculation) were done specifically to evaluate age and BMI as risk factors for postoperative complications and outcome. Results: No significant differences in patients’ age and BMI in the complication groups compared to the no-complication group could be found. No significant difference regarding the occurrence of complications could be found in any of the formed risk-groups. No significant increase of minor-, major- or overall complications, flap loss or revision surgeries were found in the elderly patient groups or for patients with overweight. Conclusion: Age and overweight do not significantly increase the risk for postoperative complications after breast reconstructions with free TMG flaps. The findings of this study support the fact that microsurgical breast reconstruction with a free TMG flap should not solely be reserved for younger patients and females with a lower BMI.

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