In a nutshell
This article aimed to examine the effectiveness of an immediate breast reconstruction (IBR) approach using DIEP-flap repair and compared it to the standard treatment of a delayed breast reconstruction (DBR) in women with breast cancer (BC) undergoing mastectomy (breast removal surgery). The authors concluded that IBR should be considered as a treatment option in these patients.
Breast reconstrucion (BR) is a key part of BC treatment in women who need a mastectomy. It can help lessen the impact that BC diagnosis and therapy can have on a patients wellbeing. BR can increase the quality of life, social aspects of patients and improve self-esteem.
A DIEP flap is a type of BR in which blood vessels called deep inferior epigastric perforators (DIEP), as well as the skin and fat connected to them, are removed from the lower belly and transferred to the chest to reconstruct a breast. This was usually done after a time period from the mastectomy. This is called a DBR approach. However, DBR can impact the quality of life of patients and involves more visits to the hospital and increased costs. An IBR appoach involves doing the BR surgery at the same time with the mastectomy. The risks associated with an IBR approach compared to a DBR approach have not been investigated.
Methods & findings
This study included the records of 3913 patients who had a mastectomy for BC. 897 patients underwent IBR-DIEP-flap procedures. 3016 patients underwent DBR-DIEP-flap procedures. The outcomes of patients were compared.
The length of hospital stay was significantly shorter in the IBR group (7.3 days) versus the DBR group (8.9 days ). Patients were also capable of movement earlier after the surgery in the IBR group. 82.1% of patients were able to move after one-day in the IBR group compared to 68.7% in the DBR group.
Revision surgery rates were lower in the IBR group (7.7%) compared to the DBR group (9.8%). The rate of patients developing collections of blood (hematoma) at the site of the BR was lower in the IBR group (2.2%) compared to 3.6% in the DBR group.
The occurrence of medical complications following BR surgery was similar in both groups.
The bottom line
The authors concluded that IBR is a good option and does not increase the risk of complications of DIEP flap.
The fine print
This study was based on medical records. Infomation might have been incomplete.
Published By :
Archives of Gynecology and Obstetrics
Sep 07, 2020
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