Jacob B Hammond, McKinna Tillotson, YooJin Yoon, Kenneth Meza Monge, Elena M Esch, James A Madura, Akshay Pratap, Julian Winocour, David W Mathes, Christodoulos Kaoutzanis
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引用次数: 0
Abstract
Background: Obese patients experience more complications after autologous breast reconstruction. This study evaluates how bariatric surgery modulates risk of complications in the setting of microvascular breast reconstruction.
Methods: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program databases were queried for patients with body mass index (BMI) greater than or equal to 35 kg/m 2 undergoing bariatric surgery from 2017 to 2022. Outcomes included BMI and obesity-related comorbidities before and 1 year after bariatric surgery. Paired Breast Reconstruction Risk Assessment scores were analyzed to evaluate risk modulation before and after bariatric surgery in the setting of microvascular breast reconstruction.
Results: A total of 1026 patients were included with an average age of 47 and BMI of 44.7 kg/m 2 . Comorbidities included hypertension ( n = 601 [59%]), type 2 diabetes ( n = 291 [28%]), and cardiovascular disease ( n = 10 [1%]). One-year outcomes after bariatric surgery included an average BMI of 32.7 kg/m 2 , with remission of type 2 diabetes in 29% of patients. Paired Breast Reconstruction Risk Assessment analysis for microvascular breast reconstruction before and after bariatric surgery showed reduction in 30-day surgical complications (40.4% versus 24.8%; P < 0.0001), with an absolute risk reduction of 15%, a relative risk reduction of 36%, and a number needed to treat of 7. Each 1-kg/m 2 reduction in preoperative BMI was associated with a 3.4% reduction in surgical complications ( P < 0.0001).
Conclusion: There is potential efficacy for metabolic bridge therapy in reducing complications for obese patients undergoing microvascular breast reconstruction.
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
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