Safety analysis of immediate breast reconstruction with deep inferior epigastric perforator after neoadjuvant treatment

Journal Title: Journal of Surgery : Concepts & Practice - Year 2023, Vol 28, Issue 2

Abstract

[Objective] To evaluate the safety of immediate breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in the patients after neoadjuvant treatment. [Methods] From January 2019 to February 2021, the data of patients with breast cancer undergoing total mastectomy and immediate breast reconstruction using DIEP flap in Comprehensive Breast Health Center, Department of General Surgery, Ruijin Hospital were collected. Comparison of clinicopathological features was done between neoadjuvant treatment group and control group. Univariate analysis was used to compare the rate of surgical complications between two groups. [Results] A total of 110 patients were enrolled with 23 cases (20.9%) in neoadjuvant treatment group and 87 cases (79.1%) in control group. None of carcinoma in situ (0 vs. 19.5%, P=0.003) and higher pTNM stage (P<0.001) was present in neoadjuvant treatment group compared with those in control group. However, there were no significant differences in the number of flap perforator of DIEP (P=0.472), the proportion of bipedicled flaps (P=0.489), operative time (P=0.651) and hospital length of stay (P=0.275) between two groups. No significant difference was found in the incidence of postoperative complications between two groups. Breast seroma was the most common recipient complication (13.0%, 3 cases) without donor complication in neoadjuvant treatment group. The most common complication was fat necrosis (12.6%, 11 cases) in recipient site and abdominal seroma (3.4%, 3 cases) in donor site of control group. Reoperation was done in one case (4.3%) of neoadjuvant treatment group and 4 cases (4.6%) of control group. DIEP flap necrosis with total flap loss occurred in 2 cases (2.3%) in control group, but none in neoadjuvant treatment group. [Conclusions] The imme-diate breast reconstruction with epigastric free flap for breast cancer patients after neoadjuvant treatment would be a safe surgical scheme.

Authors and Affiliations

Weiqi GAO, Xu ZHANG, Zheng WANG, Yifei ZHU, Jiahui HUANG, Jin HONG, Siji ZHU, Xiaosong CHEN, Ou HUANG, Jianrong HE, Weiguo CHEN, Yafen LI, Kunwei SHEN, Hua XU, Jiayi WU

Keywords

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  • EP ID EP750859
  • DOI 10.16139/j.1007-9610.2023.02.11
  • Views 27
  • Downloads 0

How To Cite

Weiqi GAO, Xu ZHANG, Zheng WANG, Yifei ZHU, Jiahui HUANG, Jin HONG, Siji ZHU, Xiaosong CHEN, Ou HUANG, Jianrong HE, Weiguo CHEN, Yafen LI, Kunwei SHEN, Hua XU, Jiayi WU (2023). Safety analysis of immediate breast reconstruction with deep inferior epigastric perforator after neoadjuvant treatment. Journal of Surgery : Concepts & Practice, 28(2), -. https://europub.co.uk./articles/-A-750859