Association Between Postoperative Complications After Immediate Alloplastic Breast Reconstruction and Oncologic Outcome

2018 ◽  
Vol 18 (4) ◽  
pp. e699-e702 ◽  
Author(s):  
Madelyn Mousa ◽  
Yoav Barnea ◽  
Udi Arad ◽  
Amir Inbal ◽  
Joseph Klausner ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Oncologic Outcome ◽  
Alloplastic Breast Reconstruction

scholarly journals The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures

2021 ◽  
Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Clinical Factors ◽  
Early Complications ◽  
Reconstructive Procedures ◽  
Factors Affecting ◽  
Rehospitalization Rate ◽  
Early Postoperative Complications

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.

scholarly journals 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

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.

scholarly journals Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Gland Surgery ◽  
2017 ◽  
Vol 6 (4) ◽  
pp. 355-367 ◽  
Author(s):  
Andri Thorarinsson ◽  
Victoria Fröjd ◽  
Lars Kölby ◽  
Mattias Lidén ◽  
Anna Elander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Independent Risk Factors

scholarly journals BMI Specific Complications Following Implant-Based Breast Reconstruction after Mastectomy

2021 ◽  
Vol 10 (23) ◽  
pp. 5665
Author(s):  
Helena Sophie Leitner ◽  
Reinhard Pauzenberger ◽  
Ines Ana Ederer ◽  
Christine Radtke ◽  
Stefan Hacker
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Positive Impact ◽  
Surgical Techniques ◽  
Study Cohort ◽  
Complication Rates ◽  
Impaired Wound Healing ◽  
Reconstruction Methods ◽  
Study Results ◽  
The Impact

Background: Breast reconstruction has a positive impact on body image and quality of life for women after experiencing the physically and psychologically demanding process of mastectomy. Previous studies have presented body mass index (BMI) as a predictor for postoperative complications after breast reconstruction, however, study results vary. This retrospective study aimed to investigate the impact of patients’ BMI on postoperative complications following implant-based breast reconstruction. Methods: All implant-based breast reconstructions performed at the Department of Plastic, Reconstructive and Aesthetic Surgery at the Medical University of Vienna from January 2001 to March 2018 were evaluated. A total of 196 reconstructed breasts among 134 patients met eligibility criteria. Demographic data, surgical techniques, as well as major and minor complications within a one-year follow-up period were analyzed. Results: Patients’ BMI did not show a significant impact on complication rates. The overall incidence of postoperative complications was 30.5% (40/131) of which 17.6% required reoperation. Impaired wound healing (18.3%), seroma (6.1%), hematoma (4.6%), capsular contraction (4.6%) and infection (3.8%) were the most common complications. Conclusion: In our study cohort, BMI was not associated with a significantly higher risk of complications. However, postoperative complications significantly increased with a longer operative time and resulted in an extended length of hospital stay.

scholarly journals Update in Direct-to-Implant Breast Reconstruction

2019 ◽  
Vol 33 (04) ◽  
pp. 264-269 ◽  
Author(s):  
Aurelia Trisliana Perdanasari ◽  
Amjed Abu-Ghname ◽  
Sarth Raj ◽  
Sebastian J. Winocour ◽  
Rene D. Largo
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Two Stage ◽  
Surgical Technology ◽  
One Stage ◽  
One Stage Reconstruction ◽  
Reconstruction Option ◽  
Implant Breast Reconstruction

AbstractImplant-based reconstruction (IBR) remains the most commonly utilized breast reconstruction option for post-mastectomy patients. IBR can be approached as either a one-stage reconstruction or a two-stage reconstruction. Facilitated by improvements in surgical technology and advanced techniques, one-stage reconstruction, also known as direct-to-implant (DTI) reconstruction, involves the insertion of an implant at the time of mastectomy. The decision to pursue either a DTI or a two-stage reconstruction is based on several factors, including the patient's overall health, expected risk of postoperative complications, and associated costs to both the patient and hospital.

Enhanced Recovery after Surgery in Breast Reconstruction: A Systematic Review

2019 ◽  
Vol 35 (09) ◽  
pp. 695-704 ◽  
Author(s):  
Carol E. Soteropulos ◽  
Sherry Y.Q. Tang ◽  
Samuel O. Poore
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Breast Reconstruction ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Fluid Management ◽  
Patient Counseling ◽  
Opioid Use ◽  
Full Spectrum ◽  
Alloplastic Breast Reconstruction

Background Enhanced Recovery after Surgery (ERAS) principles have received focused attention in breast reconstruction. Many protocols have been described in the literature for both autologous and alloplastic reconstruction. This systematic review serves to better characterize successful ERAS protocols described in the literature for potential ease of adoption at institutions desiring implementation. Methods A systematic review of ERAS protocols for autologous and alloplastic breast reconstruction was conducted using Medline, the Cochrane Database, and Web of Science. Results Eleven cohort studies evaluating ERAS protocols for autologous (n = 8) and alloplastic (n = 3) breast reconstruction were included for review. The majority compared with a retrospective cohort of traditional perioperative care. All studies described the full spectrum of implemented ERAS protocols including preoperative, intraoperative, and postoperative phases of care. Most frequently reported significant outcomes were reduced length of stay and opioid use with ERAS implementation. No significant change in major complication or readmission rate was demonstrated. Conclusion Based on this systematic review, several core elements that make up a successful perioperative enhanced recovery protocol for breast reconstruction have been identified. Elements include patient counseling and education, limited preoperative fasting, appropriate thromboprophylaxis and antibiotic prophylaxis dependent on reconstructive method, preoperative antiemetics, multimodal analgesia and use of local anesthetic, goal-directed intravenous fluid management, prompt removal of drains and catheters, early diet advancement, and encouragement of ambulation postoperatively. Implementation of ERAS protocols in both autologous and alloplastic breast reconstruction can positively enhance patient experience and improve outcomes by reducing length of stay and opioid use, without compromising successful reconstructive outcomes.

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