The impact of complications on function, health, and satisfaction following abdominally based autologous breast reconstruction: A prospective evaluation

2014 ◽  
Vol 67 (5) ◽  
pp. 682-692 ◽  
Author(s):  
Stephen M. Lu ◽  
Jonas A. Nelson ◽  
John P. Fischer ◽  
Joshua Fosnot ◽  
Jesse Goldstein ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Prospective Evaluation ◽  
Autologous Breast Reconstruction ◽  
The Impact

How Does Autologous Breast Reconstruction Impact Downtime?

2018 ◽  
Vol 34 (07) ◽  
pp. 530-536 ◽  
Author(s):  
Daniel Rais ◽  
Jian Farhadi ◽  
Giovanni Zoccali
Keyword(s):  
Breast Reconstruction ◽  
Donor Site ◽  
Diep Flap ◽  
Autologous Reconstruction ◽  
Autologous Breast Reconstruction ◽  
Superior Gluteal Artery ◽  
Free Flap Surgery ◽  
Recovery Times ◽  
Time Required ◽  
The Impact

Background Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities. Methods Multiple choice questionnaires were administered to 121 patients after recovery from autologous reconstruction to determine the times required in returning to specific physical activities. To analyze results, the analysis of variance F-test was applied, and odds ratios (ORs) were determined. Results Among the activities surveyed, recovery time was not always a function of free-flap surgery. Additional treatments and psychological effects also contributed. Adjuvant chemotherapy increased average downtime by 2 weeks, and postoperative irradiation prolonged recovery as much as 4 weeks. Patient downtime was unrelated to flap type, ranging from 2.9 to 21.3 weeks for various activities in question. Deep inferior epigastric perforator (DIEP) flaps yielded the highest OR and transverse upper gracilis (TUG) flaps the lowest. Conclusion Compared with superior gluteal artery perforator and TUG flaps, the DIEP flap was confirmed as the gold standard in autologous breast reconstruction, conferring the shortest recovery times. All adjuvant therapies served to prolong patient recovery as well. Surgical issues, patient lifestyles, and donor-site availability are other important aspects of flap selection.

The Impact of Autologous Breast Reconstruction on Body Mass Index Patterns in Breast Cancer Patients

2017 ◽  
Vol 140 (6) ◽  
pp. 1121-1131 ◽  
Author(s):  
Eugenia H. Cho ◽  
Ronnie L. Shammas ◽  
Adam D. Glener ◽  
Rachel A. Greenup ◽  
E. Shelley Hwang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Body Mass ◽  
Breast Cancer Patients ◽  
Autologous Breast Reconstruction ◽  
The Impact

The impact of obesity on abdominal wall function after free autologous breast reconstruction

Microsurgery ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 352-360 ◽  
Author(s):  
Jonas A. Nelson ◽  
John P. Fischer ◽  
Chen Yan ◽  
Joshua Fosnot ◽  
Jesse C. Selber ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Wall Function ◽  
Autologous Breast Reconstruction ◽  
The Impact ◽  
Abdominal Wall Function

Evaluating the Impact of Resident Participation and the July Effect on Outcomes in Autologous Breast Reconstruction

2018 ◽  
Vol 81 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Winona W. Wu ◽  
Caroline Medin ◽  
Alexandra Bucknor ◽  
Parisa Kamali ◽  
Bernard T. Lee ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Autologous Breast Reconstruction ◽  
Resident Participation ◽  
July Effect ◽  
The Impact

scholarly journals The Impact of Obesity on Patient-Reported Outcomes Following Autologous Breast Reconstruction

2019 ◽  
Vol 27 (6) ◽  
pp. 1877-1888 ◽  
Author(s):  
Jonas A. Nelson ◽  
Nikhil Sobti ◽  
Aadit Patel ◽  
Evan Matros ◽  
Colleen M. McCarthy ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Autologous Breast Reconstruction ◽  
Patient Reported ◽  
The Impact

The Impact of the Cosurgeon Model on Bilateral Autologous Breast Reconstruction

2017 ◽  
Vol 33 (09) ◽  
pp. 624-629 ◽  
Author(s):  
Geoffrey Hespe ◽  
Joseph Disa ◽  
Colleen McCarthy ◽  
Robert Allen ◽  
Joseph Dayan ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Retrospective Cohort ◽  
Operative Time ◽  
Multivariate Analyses ◽  
Autologous Breast Reconstruction ◽  
Postoperative Complication Rate ◽  
Working Together ◽  
American Society ◽  
The Impact ◽  
Intensive Procedures

Background Microsurgical breast reconstructions (MBRs) are time and labor intensive procedures. To circumvent these barriers, plastic surgeons have started working together as cosurgeons (CSs). This study aims to evaluate the impact of the CS model (CSM) specifically on bilateral MBR. The hypothesis is that CS procedures reduce operative time and surgical complications. Study Design This was a single institutional retrospective cohort study, which included all consecutive patients who underwent bilateral MBR from 2014 to 2016. Patients were grouped into single surgeon (SS) or CSs based on the number of the attending plastic surgeons present. Demographic and clinical characteristics including age, body mass index, smoking, American Society of Anesthesiologist class, radiation, and the timing of the reconstruction were assessed. Univariate and multivariate analyses were performed for outcomes including operative time and postoperative complications. Results Of the 136 patients included in the study, 41% had breast reconstruction performed by CSs, whereas 59% had a SS. Sociodemographic features were evenly distributed with the exception of a greater number of delayed reconstructions in the SS group (33 vs. 13%; p <0.01). Pedicle TRAMS (transverse rectus abdominis musculocutaneous flaps) were performed in 5 versus 0% of SS versus CS cases, respectively. Rates of major (4 vs. 16%) and minor (11 vs. 24%) complications were significantly lower in CS procedures. Multivariate analyses demonstrated CS operations required significantly shorter operative time by 73 minutes (p <0.001), and trended toward a reduced postoperative complication rate (p = 0.07). Conclusion The CSM is associated with improved operative efficiency for bilateral MBR. Further evaluation of the CSM may prove useful in other surgical disciplines with time and labor intense procedures.

scholarly journals The Impact of Race on Perioperative and Patient-Reported Outcomes following Autologous Breast Reconstruction

2021 ◽  
Vol 149 (1) ◽  
pp. 15-27
Author(s):  
Sabine Oskar ◽  
Jonas A. Nelson ◽  
Madeleine E. V. Hicks ◽  
Kenneth P. Seier, M.S. ◽  
Kay See Tan ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Autologous Breast Reconstruction ◽  
Patient Reported ◽  
The Impact

Rapid evaluation of FDG imaging alternatives using head-to-head comparisons of full ring and gamma camera based PET scanners –

2002 ◽  
Vol 41 (05) ◽  
pp. 208-213 ◽  
Author(s):  
L. M. Haslinghuis-Bajan ◽  
L. Hooft ◽  
A. van Lingen ◽  
M. van Tulder ◽  
W. Devillé ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Gamma Camera ◽  
First Generation ◽  
Prospective Evaluation ◽  
First Approximation ◽  
Variable Head ◽  
Malignant Lesions ◽  
The Impact ◽  
Pet Scanners

SummaryAim: While FDG full ring PET (FRPET) has been gradually accepted in oncology, the role of the cheaper gamma camera based alternatives (GCPET) is less clear. Since technology is evolving rapidly, “tracker trials” would be most helpful to provide a first approximation of the relative merits of these alternatives. As difference in scanner sensitivity is the key variable, head-to-head comparison with FRPET is an attractive study design. This systematic review summarises such studies. Methods: Nine studies were identified until July 1, 2000. Two observers assessed the methodological quality (Cochrane criteria), and extracted data. Results: The studies comprised a variety of tumours and indications. The reported GC- and FRPET agreement for detection of malignant lesions ranged from 55 to 100%, but with methodological limitations (blinding, standardisation, limited patient spectrum). Mean lesion diameter was 2.9 cm (SD 1.8), with only about 20% <1.5 cm. The 3 studies with the highest quality reported concordances of 74-79%, for the studied lesion spectrum. Contrast at GCPET was lower than that of FRPET, contrast and detection agreement were positively related. Logistic regression analysis suggested that pre-test indicators might be used to predict FRPET-GCPET concordance. Conclusion: In spite of methodological limitations, “first generation” GCPET devices detected sufficient FRPET positive lesions to allow prospective evaluation in clinical situations where the impact of FRPET is not confined to detection of small lesions (<1.5 cm). The efficiency of head-to-head comparative studies would benefit from application in a clinically relevant patient spectrum, with proper blinding and standardisation of acquisition procedures.

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