Long-term implant survival in delayed breast reconstruction.

IF 4.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2025-07-01 DOI:10.1093/bjsopen/zraf071
Fredrik Brorson, Anna Paganini, Koen Simons, Anna Elander, Emma Hansson
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Abstract

Background: The primary aim of this study was to establish the incidence of implant-related operations and revisions after delayed implant-based breast reconstruction over a 20-year period.

Methods: This study is an ancillary study to the Gothenburg Breast Reconstruction Study (GoBreast; NCT03963427). The first included patient was operated on in 2003, and the last was operated on in 2011. All breast reconstructions were delayed procedures. The Kaplan-Meier method was used to estimate the time until implant loss. Log-rank tests (Mantel-Haenszel) were used for comparisons. A Cox proportional hazards model was used for multivariable analysis, and hazard ratios were estimated.

Results: The study included 881 implants and 603 patients. The mean follow-up for the implants was 8.2 years. With regard to first implants, 17% had at least one unplanned procedure with implant failure. If all implants are pooled together, the 20-year implant survival rate is 57% (95% confidence interval 54 to 61%). Most implants were lost during the first 2 years, but the cumulative risk of implant loss increased steadily with time. When different surgical methods were compared, implant survival was statistically lower for direct-to-implant than for the other techniques (P < 0.001).

Conclusion: About half of the implants in delayed breast reconstructions in this study survived for up to two decades without any additional surgery. Serial implant revisions seem more common than single implant revisions; if the first implant needed revision, there was a tendency for the second implant to also require revision.

延迟乳房重建术中植入物的长期存活。
背景:本研究的主要目的是确定20年来延迟假体乳房重建术后假体相关手术和修复的发生率。方法:本研究是哥德堡乳房重建研究(Gothenburg Breast Reconstruction study, GoBreast;NCT03963427)。第一例患者于2003年接受手术,最后一例于2011年接受手术。所有乳房重建均为延迟手术。使用Kaplan-Meier法估计种植体脱落前的时间。采用对数秩检验(Mantel-Haenszel)进行比较。采用Cox比例风险模型进行多变量分析,并估算风险比。结果:共纳入种植体881枚,患者603例。植入物的平均随访时间为8.2年。对于首次种植体,17%的患者至少有一次计划外手术导致种植体失败。如果所有种植体合并在一起,20年种植体存活率为57%(95%置信区间为54 - 61%)。大多数种植体在前2年内丢失,但种植体丢失的累积风险随着时间的推移而稳步增加。当比较不同的手术方法时,直接种植体种植体的种植体存活率明显低于其他技术(P < 0.001)。结论:在这项研究中,大约一半的延迟乳房重建植入物存活了长达20年,而无需任何额外的手术。连续种植体修复似乎比单个种植体修复更常见;如果第一个种植体需要修复,那么第二个种植体也有需要修复的趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
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