Incidence of complications in outpatient mastectomy with immediate reconstruction
Incidence of complications in outpatient mastectomy with immediate reconstruction
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DOI：
10.1016/j.jamcollsurg.2007.03.030
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发表时间：
2007-09-01
影响因子：
5.2
通讯作者：
Bernik, Stephanie F.
中科院分区：
文献类型：
--
作者：
Simpson, Scott A.;Ying, Benjamin L.;Bernik, Stephanie F.
背景：尽管乳房手术，包括乳房切除术，越来越多地在门诊进行，但对门诊乳房切除术与立即乳房重建的安全性仍然持怀疑态度。研究表明，除了明显的经济效益外，门诊乳房手术还具有心理效益。我们试图确定门诊乳房切除术后立即重建的术后并发症发生率是否低到足以考虑该手术的安全性和有效性。研究设计：回顾性分析2000年12月至2004年6月在圣文森特综合癌症中心接受门诊乳房切除术并立即乳房重建的所有患者的图表。术后并发症的存在与否由术后期间的记录和随后的办公室就诊确定。结果：29例门诊乳房切除术立即重建患者28例（1例分别对每侧乳房进行独立手术），只有1例（3%）手术需要后续入院（出血）。其他并发症包括3例血清肿，2例蜂窝织炎需要抗生素治疗，1例血肿。总并发症发生率为24%(7 / 29)，只有14%（1 / 7）的并发症需要住院治疗。结论：这些结果表明，对于精心挑选的患者，门诊乳房切除术立即重建是一种安全有效的手术。我们患者的并发症发生率与其他发表的门诊手术报告相似，最明显的是门诊乳房切除术不立即重建。
BACKGROUND: Although breast surgery, including mastectomy, is increasingly being performed on an outpatient basis, skepticism remains about the safety of outpatient mastectomy with immediate breast reconstruction. Studies have demonstrated a psychologic benefit to outpatient breast surgery in addition to the clear financial benefit. We sought to determine whether or not the postoperative complication rate after outpatient mastectomy with immediate reconstruction is low enough to consider the procedure safe and effective.STUDY DESIGN: Charts were retrospectively reviewed for all patients who underwent outpatient mastectomies with immediate breast reconstruction at St Vincent's Comprehensive Cancer Center between December 2000 and June 2004. The presence or absence of postoperative complications was determined from records during the postoperative period and subsequent office visit.RESULTS: Of 29 outpatient mastectomies with immediate reconstruction performed on 28 patients (one had independent procedures on each breast), only one procedure (3%) required subsequent admission to the hospital (for bleeding). Other complications included three seromas, two cases of cellulitis requiring antibiotics, and one hematoma. The overall complication rate was 24% (7 of 29), with only 14% (1 of 7) of the complications requiring hospitalization.CONCLUSIONS: These results demonstrate that outpatient mastectomy with immediate reconstruction is a safe and effective procedure for carefully selected patients. The complication rates for our patient population are similar to those in other published reports on outpatient operations, most notably, those of outpatient mastectomy without immediate reconstruction.