Variables associated with length of stay in patients undergoing mastectomy and delayed‐immediate breast reconstruction with tissue expander

2019 ◽  
Vol 25 (5) ◽  
pp. 927-931 ◽  
Author(s):  
Joanna Manum ◽  
Jacob Veith ◽  
Guo Wei ◽  
Alvin Kwok ◽  
Jayant Agarwal
Keyword(s):  
Length Of Stay ◽  
Breast Reconstruction ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction

Does Immediate Tissue Expander Placement Increase Immediate Postoperative Complications in Patients with Breast Cancer?

2015 ◽  
Vol 81 (2) ◽  
pp. 143-149
Author(s):  
Hossein Masoomi ◽  
Keyianoosh Z. Paydar ◽  
Gregory R. D. Evans ◽  
Emily Tan ◽  
Karen T. Lane ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Hospital Mortality ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Tissue Expander ◽  
The United States ◽  
Immediate Breast Reconstruction ◽  
Perioperative Outcomes ◽  
Immediate Reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

Assessing Outcomes and Safety of Inpatient Versus Outpatient Tissue Expander Immediate Breast Reconstruction

2015 ◽  
Vol 22 (11) ◽  
pp. 3724-3729 ◽  
Author(s):  
Charles Qin ◽  
Anuja K. Antony ◽  
Apas Aggarwal ◽  
Sumanas Jordan ◽  
Karol A. Gutowski ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction

Allograft vs Xenograft Bioprosthetic Mesh in Tissue Expander Breast Reconstruction: A Blinded Prospective Randomized Controlled Trial

2021 ◽  
Author(s):  
Malke Asaad ◽  
Jesse C Selber ◽  
David M Adelman ◽  
Donald P Baumann ◽  
Victor J Hassid ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Tissue Expander ◽  
Final Analysis ◽  
Immediate Breast Reconstruction ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Dermal Matrix ◽  
Randomized Controlled

Abstract Background With the increased use of acellular dermal matrix (ADM) in breast reconstruction, the number of available materials has increased. There is a relative paucity of high-quality outcomes data for use of different ADMs. Objectives The goal of this study was to compare the outcomes between a human (HADM) and a bovine ADM (BADM) in implant-based breast reconstruction. Methods A prospective, single-blinded, randomized controlled trial was conducted to evaluate differences in outcomes between HADM and BADM for patients undergoing immediate tissue expander breast reconstruction. Patients with prior radiation to the index breast were excluded. Patient and surgical characteristics were collected and analyzed. Results From April 2011 to June 2016, a total of 90 patients were randomized to a mesh group, with 68 patients (HADM, 36 patients/55 breasts; BADM, 32 patients/48 breasts) included in the final analysis. Baseline characteristics were similar between the 2 groups. No significant differences in overall complication rates were identified between HADM (n = 14, 25%) and BADM (n = 13, 27%) (P = 0.85). Similar trends were identified for major complications and complications requiring reoperation. Tissue expander loss was identified in 7% of HADM patients (n = 4) and 17% of BADM patients (n = 8) (P = 0.14). Conclusions Similar complication and implant loss rates were found among patients undergoing immediate tissue expander breast reconstruction with HADM or BADM. Regardless of what material is used, careful patient selection and counseling, and cost consideration, help to improve outcomes and sustainability in immediate breast reconstruction. Level of Evidence: 2

scholarly journals Does chemotherapy or radiotherapy affect the postoperative complication in breast cancer patients who underwent immediate breast reconstruction with tissue expander?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sung Mi Jung ◽  
Byung-Joon Jeon ◽  
Jinsun Woo ◽  
Jai Min Ryu ◽  
Se Kyung Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Patients ◽  
The Impact ◽  
To Receive

Abstract Background Immediate breast reconstruction with tissue expander in breast cancer patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander. Methods We conducted a retrospective study of 1081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1022 patients (94.5%). Results In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications. Conclusions IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR. Trial registration Patients were selected and registered retrospectively, and medical records were evaluated.

scholarly journals Azonnali, postmastectomiás emlőrekonstrukciókkal szerzett tapasztalatok. Száz eset klinikopatológiai utánkövetése és a kozmetikai eredmények felmérése

2016 ◽  
Vol 157 (46) ◽  
pp. 1830-1838
Author(s):  
Dávid Pukancsik ◽  
Péter Kelemen ◽  
Ákos Sávolt ◽  
Mihály Újhelyi ◽  
Eszter Kovács ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Breast Reconstruction ◽  
Tissue Expander ◽  
Operation Time ◽  
Immediate Breast Reconstruction ◽  
Cosmetic Outcome ◽  
Oncological Safety ◽  
Effective Option ◽  
Radiological Control ◽  
Duration Of Operation

Introduction: Immediate breast reconstruction provides oncological safety, requires longer operation time. It does not influence the initiation of adjuvant therapy and radiological control, and results in favourable cosmetic outcome. Aim: Assessing the Hungarian data of immediate postmastectomy breast reconstructions, and comparing them to international findings. Method: Between May, 2011 and September, 2014 121 therapeutic and prophylactic, postmastectomy immediate breast reconstructions were performed in 100 patients. The clinico-pathological findings were assessed retrospectively, and surgical, oncological and cosmetic outcomes were evaluated statistically. Results: The mean age of patients was 42.6 years, the follow up time was 29.4 months, and the duration of operation was 132 minutes. Skin-sparing mastectomy was performed most commonly (64%) with submuscular tissue expander placement (70%). Early postoperative complication was identified in 18 patients, and loco-regional recurrence in 1 patient. Most patients (89%) were satisfied with the cosmetic outcome. The average initiation time of adjuvant therapy was 4.8 weeks. Conclusions: Immediate breast reconstruction is a safe and effective option in line with international findings. Orv. Hetil., 2016, 157(46), 1830–1838.

scholarly journals 1443 Comparison of Outcomes Between Immediate Direct-to-Implant Breast Reconstruction versus Two-Stage Implant Breast Reconstruction; a Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Kelly ◽  
I Balasubramanian ◽  
C Cullinane ◽  
R Prichard
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Meta Analysis ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Two Stage ◽  
Significant Difference ◽  
Implant Reconstruction ◽  
Implant Breast Reconstruction

Abstract Background Direct-to-implant (DTI) breast reconstruction is increasingly performed as the preferred method of immediate breast reconstruction following mastectomy. The proposed advantages of DTI over two-stage tissue expander (TE)/implant reconstruction relate to fewer surgical procedures. This systematic review and meta-analysis aims to evaluate the safety and efficacy of DTI versus conventional TE/implant breast reconstruction. Method A systematic review was performed (PubMed, Embase, Scopus) to identify relevant studies that compared outcomes between DTI and TE/Implant reconstructions. Publications up to October 2020 were included. The primary outcome was overall complication rate. Secondary outcomes included infection rate and implant loss. Results Nineteen studies, including 32,971 implant-based breast reconstructions, were analysed. Median age was 48 years. Mean BMI was 25.9. There was no statistically significant difference between the two groups. Duration of follow up ranged from 1-60 months. Overall complications were significantly more likely to occur in the DTI group (OR 1.81 [1.17-2.79]). Overall complications refers to all reported complications including seroma, haematoma, would dehiscence, infection, skin necrosis and capsular contracture. Implant loss was also significantly higher in the DTI cohort (OR 1.31 [1.12-1.78]). There was no significant difference in infection rates between the two groups. Subgroup analyses, focusing on high-powered multicentre studies showed that the risks of overall complications were significantly higher in the DTI group (OR 1.51 [1.06-2.14]). Conclusions This meta-analysis demonstrates significantly greater risk of complications and implant loss in the DTI breast reconstruction group. These findings serve to aid both patients and clinicians in the decision-making process regarding implant reconstruction following mastectomy

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