Delayed breast reconstruction with autologous free flap after radiation therapy: vascular complications and aesthetic outcomes.

IF 4 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Cancer Pub Date : 2024-09-01 Epub Date: 2024-06-12 DOI:10.1007/s12282-024-01593-3

Kimie Miyazawa, Toshihiko Satake, Mayu Muto, Yui Tsunoda, Tomoyuki Koike, Kazutaka Narui, Ryohei Katsuragi, Satoshi Onoda, Takashi Ishikawa

{"title":"Delayed breast reconstruction with autologous free flap after radiation therapy: vascular complications and aesthetic outcomes.","authors":"Kimie Miyazawa, Toshihiko Satake, Mayu Muto, Yui Tsunoda, Tomoyuki Koike, Kazutaka Narui, Ryohei Katsuragi, Satoshi Onoda, Takashi Ishikawa","doi":"10.1007/s12282-024-01593-3","DOIUrl":null,"url":null,"abstract":"Background: The safety and outcome of breast reconstruction after radiotherapy are controversial, and the aesthetic aspects have not been studied extensively. We compared the results of vascular anastomosis, the incidence of postoperative complications, and aesthetic appearance between patients who had and had not received radiotherapy who then had undergone delayed breast reconstruction with autologous free flaps from the abdomen, thighs, and buttocks.Methods: In total, 257 flaps in 241 patients were investigated; 194 and 63 flaps implanted in patients who did not receive radiotherapy and who received radiotherapy before breast reconstruction, respectively. Of the 257 flaps, 221, 20, 14, and 2 came from the abdomen, thighs, buttocks, and other anatomic locations, respectively. We evaluated aesthetic outcomes in 105 patients who had not received radiotherapy and 35 who had.Results: We found no significant differences between the two groups in the incidence of vascular reanastomosis, the time required for anastomosis, or the incidence of unplanned reoperation. Complications such as flap necrosis were rare in both groups. Aesthetic outcomes were significantly better in the patients who had not received radiotherapy.Conclusions: Breast reconstruction with autologous free flaps can be performed safely in patients who have received radiotherapy, but the aesthetic result is slightly inferior to that in patients who had not received radiotherapy.","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":null,"pages":null},"PeriodicalIF":4.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12282-024-01593-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/12 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The safety and outcome of breast reconstruction after radiotherapy are controversial, and the aesthetic aspects have not been studied extensively. We compared the results of vascular anastomosis, the incidence of postoperative complications, and aesthetic appearance between patients who had and had not received radiotherapy who then had undergone delayed breast reconstruction with autologous free flaps from the abdomen, thighs, and buttocks.

Methods: In total, 257 flaps in 241 patients were investigated; 194 and 63 flaps implanted in patients who did not receive radiotherapy and who received radiotherapy before breast reconstruction, respectively. Of the 257 flaps, 221, 20, 14, and 2 came from the abdomen, thighs, buttocks, and other anatomic locations, respectively. We evaluated aesthetic outcomes in 105 patients who had not received radiotherapy and 35 who had.

Results: We found no significant differences between the two groups in the incidence of vascular reanastomosis, the time required for anastomosis, or the incidence of unplanned reoperation. Complications such as flap necrosis were rare in both groups. Aesthetic outcomes were significantly better in the patients who had not received radiotherapy.

Conclusions: Breast reconstruction with autologous free flaps can be performed safely in patients who have received radiotherapy, but the aesthetic result is slightly inferior to that in patients who had not received radiotherapy.

Abstract Image

查看原文本刊更多论文

放疗后延迟使用自体游离皮瓣进行乳房重建：血管并发症和美学效果。

背景：放疗后乳房再造的安全性和结果存在争议，美学方面的研究也不多。我们比较了接受过和未接受过放疗的患者使用腹部、大腿和臀部的自体游离皮瓣进行延迟乳房再造时的血管吻合效果、术后并发症发生率和美学外观：共对 241 名患者的 257 个皮瓣进行了调查；未接受放疗和在乳房重建前接受放疗的患者分别植入了 194 个和 63 个皮瓣。在 257 个皮瓣中，221 个、20 个、14 个和 2 个分别来自腹部、大腿、臀部和其他解剖位置。我们对 105 名未接受过放疗的患者和 35 名接受过放疗的患者的美学效果进行了评估：结果：我们发现两组患者在血管再吻合的发生率、吻合所需的时间和意外再手术的发生率上没有明显差异。两组都很少发生皮瓣坏死等并发症。未接受放射治疗的患者的美学效果明显更好：结论：接受过放疗的患者可以安全地使用自体游离皮瓣进行乳房重建，但其美学效果略逊于未接受过放疗的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.70

自引率

2.50%

发文量

105

审稿时长

6-12 weeks

期刊介绍： Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.