Microsurgery · 2024
Comparing Safety Profiles of Skin-Sparing and Nipple-Sparing Mastectomy With Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Retrospective Analysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Blazel Madeleine M, Quick Joseph D, Schafer Rachel E, Shukla Priya, Wu Shannon S, Bernard Steven, Schwarz Graham, Djohan Risal, Gurunian Raffi, Bishop Sarah N
Аннотация
BACKGROUND: Mastectomy is performed prior to or concurrently with deep inferior epigastric perforator (DIEP) flap breast reconstruction. However, the complication rates of nipple-sparing mastectomy (NSM) versus skin-sparing mastectomy (SSM) with DIEP are not well-characterized.
METHODS: This retrospective study included patients who underwent SSM or NSM with DIEP reconstruction between January 2019 and July 2022 at an academic institution. The primary outcome was 30-day postoperative complication rate. Variables were compared using Student's t-tests/Wilcoxon rank-sum and Chi-square/Fisher's exact tests.
RESULTS: Of 535 patients, 195 (36%) underwent NSM and 340 (64%) underwent SSM. The 30-day postoperative complication rates did not differ between cohorts (16.4% in NSM vs. 16.8% in SSM, p > 0.9). The NSM cohort had a higher rate of any flap necrosis (9.2% vs. 3.5%, p = 0.01) compared to the SSM cohort, though rates of total DIEP flap loss rate did not differ (4.1% vs. 1.5% respectively). Site-wide total DIEP flap loss was 2.4%. The NSM cohort had smaller preoperative sternal notch-to-nipple distances (25.0 vs. 26.5 cm, p < 0.001) and had lower rates of preoperative radiation therapy (28.2% vs. 42.9%, p < 0.002) compared to the SSM cohort. The cohorts did not differ in demographic or operative variables including reconstruction timing (delayed vs. immediate interval), readmission, and reoperation.
CONCLUSIONS: Individuals who received an NSM prior to DIEP reconstruction had more flap complications compared to the SSM cohort. Both cohorts had comparable overall 30-day postoperative complication rates and demographic variables, and rate of total DIEP flap loss was 2.4%. Patient preference can further guide surgical decision-making.
METHODS: This retrospective study included patients who underwent SSM or NSM with DIEP reconstruction between January 2019 and July 2022 at an academic institution. The primary outcome was 30-day postoperative complication rate. Variables were compared using Student's t-tests/Wilcoxon rank-sum and Chi-square/Fisher's exact tests.
RESULTS: Of 535 patients, 195 (36%) underwent NSM and 340 (64%) underwent SSM. The 30-day postoperative complication rates did not differ between cohorts (16.4% in NSM vs. 16.8% in SSM, p > 0.9). The NSM cohort had a higher rate of any flap necrosis (9.2% vs. 3.5%, p = 0.01) compared to the SSM cohort, though rates of total DIEP flap loss rate did not differ (4.1% vs. 1.5% respectively). Site-wide total DIEP flap loss was 2.4%. The NSM cohort had smaller preoperative sternal notch-to-nipple distances (25.0 vs. 26.5 cm, p < 0.001) and had lower rates of preoperative radiation therapy (28.2% vs. 42.9%, p < 0.002) compared to the SSM cohort. The cohorts did not differ in demographic or operative variables including reconstruction timing (delayed vs. immediate interval), readmission, and reoperation.
CONCLUSIONS: Individuals who received an NSM prior to DIEP reconstruction had more flap complications compared to the SSM cohort. Both cohorts had comparable overall 30-day postoperative complication rates and demographic variables, and rate of total DIEP flap loss was 2.4%. Patient preference can further guide surgical decision-making.