Early Complications in Prepectoral Tissue Expander-Based Breast Reconstruction

被引:3
作者
Rubenstein, Robyn N. [1 ]
Kim, Minji [1 ]
Plotsker, Ethan L. [1 ]
Chu, Jacqueline J. [1 ]
Bell, Tajah [1 ]
McGriff, De'von [1 ]
Allen, Robert [1 ]
Dayan, Joseph H. [1 ]
Stern, Carrie S. [1 ]
Coriddi, Michelle [1 ]
Disa, Joseph J. [1 ]
Mehrara, Babak J. [1 ]
Matros, Evan [1 ]
Nelson, Jonas A. [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Plast & Reconstruct Surg Serv, New York, NY 10065 USA
关键词
ACELLULAR DERMAL MATRIX; PECTORALIS MAJOR MUSCLE; DIRECT-TO-IMPLANT; ANIMATION DEFORMITY; SPARING MASTECTOMY; RISK-FACTORS; PLACEMENT; OUTCOMES; PREDICTORS;
D O I
10.1245/s10434-023-14861-x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Prepectoral implant placement for postmastectomy breast reconstruction has increased in recent years. Benefits of prepectoral reconstruction may include lack of animation deformities and reduced postoperative pain, but its complication profile is currently unclear. This study aimed to examine the complication profile of prepectoral tissue expanders (TEs) to determine factors associated with TE loss. Methods. A retrospective review was performed to identify all patients who underwent immediate prepectoral TE reconstruction from January 2018 to June 2021. The decision to use the prepectoral technique was based on mastectomy skin quality and patient comorbidities. Patient demographics, comorbidities, and operative details were evaluated. Outcomes of interest included TE loss, seroma, hematoma, infection/cellulitis, mastectomy skin flap necrosis requiring revision, and TE exposure. Logistic regression analysis was performed to identify factors associated with TE loss. Results. The study identified 1225 TEs. The most frequent complications were seroma (8.7%, n = 106), infection/cellulitis (8.2%, n = 101), and TE loss (4.2%, n = 51). Factors associated with TE loss in the univariate analysis included ethnicity, history of smoking, body mass index, mastectomy weight, and neoadjuvant chemotherapy. In the multivariate regression analysis, only mastectomy weight had a positive association with TE loss (odds ratio, 1.001; p = 0.016). Conclusion. Prepectoral two-stage breast reconstruction can be performed safely with an acceptable early complication profile. The study data suggest that increasing mastectomy weight is the most significant factor associated with TE loss. Further research examining the quality of the soft tissue envelope and assessing patient-reported outcomes would prove beneficial.
引用
收藏
页码:2766 / 2776
页数:11
相关论文
共 52 条
[1]  
[Anonymous], 2020, 2020 Plastic Surgery Statistics Report
[2]  
Apfelberg D B, 1981, Ann Plast Surg, V7, P213
[3]   Surgeon-Controlled Comparison of Direct-to-Implant and 2-Stage Tissue Expander-Implant Immediate Breast Reconstruction Outcomes [J].
Azouz, Vitali ;
Lopez, Stephen ;
Wagner, Douglas S. .
ANNALS OF PLASTIC SURGERY, 2018, 80 (03) :212-216
[4]   Immediate Implant-based Prepectoral Breast Reconstruction Using a Vertical Incision [J].
Hilton, Becker ;
Lind, Jeffrey G., II ;
Hopkins, Elizabeth G. .
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 2015, 3 (06)
[5]   Evaluation of a novel breast reconstruction technique using the Braxon® acellular dermal matrix: a new muscle-sparing breast reconstruction [J].
Berna, Giorgio ;
Cawthorn, Simon J. ;
Papaccio, Guido ;
Balestrieri, Nicola .
ANZ JOURNAL OF SURGERY, 2017, 87 (06) :493-498
[6]   Subcutaneous Direct-to-Implant Breast Reconstruction: Surgical, Functional, and Aesthetic Results after Long-Term Follow-Up [J].
Bernini, Marco ;
Calabrese, Claudio ;
Cecconi, Lorenzo ;
Santi, Caterina ;
Gjondedaj, Ulpjana ;
Roselli, Jenny ;
Nori, Jacopo ;
Fausto, Alfonso ;
Orzalesi, Lorenzo .
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 2015, 3 (12)
[7]   Complication Rates of Radiation on Tissue Expander and Autologous Tissue Breast Reconstruction [J].
Berry, Tiffany ;
Brooks, Suzanne ;
Sydow, Nicole ;
Djohan, Risal ;
Nutter, Benjamin ;
Lyons, Joanne ;
Dietz, Jill .
ANNALS OF SURGICAL ONCOLOGY, 2010, 17 :S202-S210
[8]   Subcutaneous Tissue Expander Placement with Synthetic Titanium-Coated Mesh in Breast Reconstruction: Long-term Results [J].
Casella, Donato ;
Calabrese, Claudio ;
Bianchi, Simonetta ;
Meattini, Icro ;
Bernini, Marco .
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 2015, 3 (12)
[9]   One-Step Prepectoral Breast Reconstruction With Dermal Matrix-Covered Implant Compared to Submuscular Implantation: Functional and Cost Evaluation [J].
Cattelani, Leonardo ;
Polotto, Susanna ;
Arcuri, Maria Francesca ;
Pedrazzi, Giuseppe ;
Linguadoca, Chiara ;
Bonati, Elena .
CLINICAL BREAST CANCER, 2018, 18 (04) :E703-E711
[10]   Risk factors for complications following immediate tissue expander based breast reconstruction in Taiwanese population [J].
Chang, Che-Wei ;
Tai, Hao-Chih ;
Cheng, Nai-Chen ;
Li, Wei-Tang ;
Lai, Hong-Shiee ;
Chien, Hsiung-Fei .
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION, 2017, 116 (01) :57-63