An Analysis of the Motivating and Risk Factors for Conversion from Implant-Based to Total Autologous Breast Reconstruction

2013 ◽  
Vol 132 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Sujatha Tadiparthi ◽  
Helen Staley ◽  
Nicholas Collis ◽  
Joe M. O’Donoghue
Author(s):  
Luís Mata Ribeiro ◽  
Rita P. Meireles ◽  
Irís M. Brito ◽  
Patrícia M. Costa ◽  
Marco A. Rebelo ◽  
...  

2020 ◽  
Vol 145 (3) ◽  
pp. 475e-480e
Author(s):  
Jill P. Stone ◽  
Ricardo J. Bello ◽  
Charalampos Siotos ◽  
Meredith L. Meyer ◽  
Mohamad E. Sebai ◽  
...  

2020 ◽  
Vol 80 (06) ◽  
pp. 628-638 ◽  
Author(s):  
Beatrix Munder ◽  
Christoph Andree ◽  
Christian Witzel ◽  
Sonia Fertsch ◽  
Peter Stambera ◽  
...  

Abstract Background Breast cancer is the most common cancer affecting women in Germany. Despite breast-conserving therapy (BCT) being carried out in almost 70% of cases, a high number of women still require complete mastectomy. Prophylactic mastectomy is also indicated for women with a BRCA 1/2 gene mutation. In addition to implant-based heterologous breast reconstruction, autologous breast reconstruction using a DIEP flap has been found to be beneficial, particularly for patients who had prior radiotherapy. This study aims to show that DIEP flap reconstruction surgery is the method of choice for autologous breast reconstruction with a low rate of complications. Patients and Methods Autologous breast reconstruction using a DIEP flap was performed in 1124 patients between July 2004 and December 2014. Retrospective study criteria included potential risk factors such as age, BMI, smoking, chemotherapy and/or radiotherapy, and comorbidities as well as outcome parameters such as postoperative complications. Outcomes were evaluated with a mean follow-up of 24 months. Results A total of 1124 patients underwent 1274 free DIEP flap breast reconstructions, of which 150 were bilateral reconstructions. The primary indication was previous mastectomy in 785 cases, followed by prior implant-based reconstruction in 265 cases. The total flap loss rate was 0.6%. Postoperative surgical revision for abdominal wall hernia was required in 0.2% of cases. The group with a higher BMI and the group of smokers had significantly higher complication rates. Elderly patients (> 65 years), patients who had undergone chemo-/radiotherapy and patients with diabetes did not have higher complication rates. Conclusion DIEP flap surgery is an excellent option for autologous breast reconstruction, with a low rate of donor site morbidity and low complication rates. DIEP flap surgery carried out in a specialised interdisciplinary breast centre in a standardised clinical setting after prior careful patient selection to take account of risk factors such as high BMI and smoking is a reliable method with a low complication rate and satisfactory long-term reconstruction results.


2016 ◽  
Vol Volume 9 ◽  
pp. 6829-6834 ◽  
Author(s):  
Siyu Wu ◽  
Miao Mo ◽  
Yujie Wang ◽  
Na Zhang ◽  
Jianwei Li ◽  
...  

2014 ◽  
Vol 72 (1) ◽  
pp. 30-33 ◽  
Author(s):  
Hossein Masoomi ◽  
Keyianoosh Z. Paydar ◽  
Garrett A. Wirth ◽  
Al Aly ◽  
Mark R. Kobayashi ◽  
...  

2020 ◽  
Vol 26 (11) ◽  
pp. 2223-2225
Author(s):  
Domenico Costanzo ◽  
Marco Klinger ◽  
Andrea Lisa ◽  
Luca Maione ◽  
Andrea Battistini ◽  
...  

Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau

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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