Risk factors of postoperative complications of breast reconstruction with abdominal flaps
10.3760/cma.j.cn113855-20230327-00150
- VernacularTitle:腹部皮瓣乳房再造术后并发症的危险因素分析
- Author:
Cong SU
1
;
Shu WANG
;
Bowen DING
;
Shanshan HE
;
Chunyong HAN
;
Zhuming YIN
;
Jian YIN
Author Information
1. 天津医科大学肿瘤医院乳房再造科 国家恶性肿瘤临床医学研究中心 天津市肿瘤防治重点实验室 天津市恶性肿瘤临床医学研究中心 乳腺癌防治教育部重点实验室 中俄乳腺肿瘤整形联合研究中心，天津 300060
- Keywords:
Mammaplasty;
Postoperative complications;
Risk factors
- From:
Chinese Journal of General Surgery
2024;39(7):539-543
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the postoperative complications and its risk factors in patients undergoing breast reconstruction with abdominal flaps.Methods:The clinical data of patients undergoing breast reconstruction with abdominal flaps at Department of Breast Oncoplastic Surgery, Tianjin Medical University Cancer Institute and Hospital from Jan 2011 to Apr 2022 were reviewed.Results:Postoperative complications occurred in 95 of 484 patients (19.6%), 15.5% had flap complications, 5.2% had donor-site complications, and fat necrosis was the most common complication (11.9%). The rate of fat liquefaction decreased significantly through technical improvement (1.7% vs. 7.0%); By univariate analysis, there were statistically significant differences among the groups by reconstructive type, neoadjuvant chemotherapy, BMI, smoking history ( χ2=21.088, P<0.001; χ2=4.385, P=0.036; χ2=14.784, P=0.018; χ2=19.015, P=0.048). Unplanned reoperation statistically related to the timing of reconstruction, and reconstructive type ( χ2=7.316, P=0.007; χ2=17.167, P<0.001). Revision surgery significantly related to the timing of reconstruction and timing of radiation ( χ2=40.785, P<0.001; χ2=18.602, P<0.001);By multivariate analysis, deep inferior epigastric perforator flap, smoking history were independent risk factors for flap necrosis ( OR=0.084, 95% CI:0.022-0.325, P<0.001; OR=41.623, 95% CI:3.241-534.569, P=0.004) . Conclusions:Complications after breast reconstruction with abdominal flaps are related to many factors. The surgical risks should be carefully evaluated and personalized plan should be formulated before surgery.
