Impact of demographic and perioperative risk factors on complication rates in skin-sparing/nipple-sparing mastectomy with implant-based reconstruction using titanized polypropylene mesh (TiLOOP® Bra)

2021 ◽  
pp. 101675
Author(s):  
Viktoria Michno ◽  
Wolfram Malter ◽  
Stefan Paepke ◽  
Marc Thill ◽  
Katharina Kelling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Polypropylene Mesh ◽  
Perioperative Risk ◽  
Complication Rates ◽  
Perioperative Risk Factors ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Risk Factors for Complications after Skin-Sparing and Nipple-Sparing Mastectomy

Breast Care ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. 289-297
Author(s):  
Felix J. Paprottka ◽  
Christopher L. Schlett ◽  
Rosalia Luketina ◽  
Karolin Paprottka ◽  
Dalius Klimas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Breast Reconstruction ◽  
Breast Tissue ◽  
Patient Characteristics ◽  
Personal History ◽  
Complication Rates ◽  
History Of ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Introduction: In order to achieve a complication-free breast reconstruction, it is fundamental for each individual patient case to determine preoperatively certain risk factors that might have a negative impact on the postoperative result after skin-sparing (SSM) or nipple-sparing mastectomy (NSM). Methods: A retrospective study of 39 female breast cancer patients who received SSM or NSM breast reconstruction in our department (time interval: 2010–2015), was performed. The study focus is on determining patient characteristics (e.g., demographics, history of radiotherapy/chemotherapy, menopausal status, amount of resected breast tissue) leading to higher complication rates. Results: Overall, 50 mastectomies (27 SSM and 23 NSM) with 6 immediate and 35 immediate 2-stage tissue expander breast reconstructions amounting to a total of 41 surgical interventions (n = 41) were carried out. Median follow-up time was 2 years and 5 months (range 121–1,863 days). Increased complication rates were associated with the following patient characteristics: age >50 years (p < 0.05) and personal history of cardiovascular disease (p < 0.05). Increased but not significant risk factors included postmenopausal status (p = 0.07), radiotherapy prior to SSM/NSM (p = 0.06), and weight of resected breast tissue >438 g (p = 0.09). Conclusion: This work identified age >50 years and personal history of cardiovascular disease to be risk factors for increased complication rates following SSM and NSM. Therefore, the given findings should be taken into account when selecting patients for these 2 procedures.

scholarly journals Robotic nipple-sparing mastectomy complication rate compared to traditional nipple-sparing mastectomy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
M. D. Filipe ◽  
E. de Bock ◽  
E. L. Postma ◽  
O. W. Bastian ◽  
P. P. A. Schellekens ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Complication Rate ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Complication Rates ◽  
Flap Necrosis ◽  
Postoperative Complication Rate ◽  
Common Cancer ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

AbstractBreast cancer is worldwide the most common cause of cancer in women and causes the second most common cancer-related death. Nipple-sparing mastectomy (NSM) is commonly used in therapeutic and prophylactic settings. Furthermore, (preventive) mastectomies are, besides complications, also associated with psychological and cosmetic consequences. Robotic NSM (RNSM) allows for better visualization of the planes and reducing the invasiveness. The aim of this study was to compare the postoperative complication rate of RNSM to NSM. A systematic search was performed on all (R)NSM articles. The primary outcome was determining the overall postoperative complication rate of traditional NSM and RNSM. Secondary outcomes were comparing the specific postoperative complication rates: implant loss, hematoma, (flap)necrosis, infection, and seroma. Forty-nine studies containing 13,886 cases of (R)NSM were included. No statistically significant differences were found regarding postoperative complications (RNSM 3.9%, NSM 7.0%, p = 0.070), postoperative implant loss (RNSM 4.1%, NSM 3.2%, p = 0.523), hematomas (RNSM 4.3%, NSM 2.0%, p = 0.059), necrosis (RNSM 4.3%, NSM 7.4%, p = 0.230), infection (RNSM 8.3%, NSM 4.0%, p = 0.054) or seromas (RNSM 3.0%, NSM 2.0%, p = 0.421). Overall, there are no statistically significant differences in complication rates between NSM and RNSM.

PERIOPERATIVE RISK FACTORS OF HEMODIALYSIC PATIENTS IN GASTROINTESTINAL SURGERY

1998 ◽  
Vol 59 (11) ◽  
pp. 2740-2746 ◽  
Author(s):  
Minako KIKUCHI ◽  
Shinji TOGO ◽  
Chikara KUNISAKI ◽  
Kouichiro MISUTA ◽  
Hiroshi SHIMADA
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Surgery ◽  
Perioperative Risk ◽  
Perioperative Risk Factors

scholarly journals Persistent nipple discharge after nipple-sparing mastectomy secondary to unincorporated AlloDerm: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Avra S. Laarakker ◽  
Audrey Rich ◽  
Jeffrey Wu ◽  
Stephanie Fine
Keyword(s):  
Case Report ◽  
Fluid Collection ◽  
Nipple Discharge ◽  
Rare Event ◽  
Silicone Implants ◽  
Complication Rates ◽  
Reconstructive Procedures ◽  
First Case ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Background Rates of nipple-sparing mastectomies have increased over the past decade. In 2017, acellular dermal matrix was used in 56% of breast reconstructive procedures, with complication rates similar to operations without AlloDerm. Although persistent nipple discharge after nipple-sparing mastectomy is a rare event, it has been described in the literature. Other authors have described evaluation and treatment on a case-by-case basis. To the best of our knowledge, this is the first case report to describe a persistent unilateral discharge after multiple operative revisions and to provide an algorithmic approach to workup and treatment. Case presentation We present a case of a 29-year-old Hispanic woman with BRCA1 mutation who underwent a prophylactic bilateral nipple-sparing mastectomy with immediate reconstruction using AlloDerm. The year following her operation, the patient underwent two surgical revisions, one for implant rippling and one for asymmetry. Six months after her second revision, she presented to our hospital with a capsular contracture and unilateral clear nipple discharge. Her breast ultrasound showed dilated subareolar ducts and a suspicious mass. Magnetic resonance imaging identified a benign-appearing, rim-enhancing fluid collection. She underwent a third revision. One year later, she returned to our clinic with bloody nipple discharge, erythematous skin changes, and a palpable breast lump. Her surgical biopsy showed a fold in AlloDerm and chronic inflammatory changes. She continued experiencing discharge and opted for nipple excision. During the operation, a lacrimal probe demonstrated a direct connection between the discharging external duct and a seroma associated with an area of unincorporated AlloDerm. The section of unincorporated AlloDerm was excised, and no evidence of malignancy was identified. Ten months later, the patient remained symptom-free and had progressed to placement of final silicone implants. Conclusions To the best of our knowledge, this is the first case report to describe a nongravid patient with persistent unilateral sanguineous nipple discharge after multiple operative revisions. A visible communication between the draining duct and a seroma associated with unincorporated AlloDerm was ultimately identified. We present a clinical algorithm for patients with nipple discharge after nipple-sparing mastectomy.

scholarly journals Acute Kidney Injury After Lung Transplantation: Perioperative Risk Factors and Outcome

2020 ◽  
Vol 52 (3) ◽  
pp. 967-976 ◽  
Author(s):  
E. Atchade ◽  
S. Barour ◽  
A. Tran-Dinh ◽  
S. Jean-Baptiste ◽  
S. Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Perioperative Risk ◽  
Perioperative Risk Factors
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