OB/GYN and Women's Health Institute, Cleveland, Ohio, 44195, USA.
Breast J. 2012 Jan-Feb;18(1):28-34. doi: 10.1111/j.1524-4741.2011.01182.x. Epub 2011 Nov 20.
Radiation therapy has been shown to increase complication rates of tissue expander/implant breast reconstructions. The purpose of this study was to evaluate patient characteristics to assess their impact on complications. A retrospective review of patients who underwent mastectomy plus tissue expander/implant reconstruction from January 2000 to December 2006 was performed. The main outcome of interest was the development of postoperative complications. Analyses were performed to detect risk factors for complications. A total of 560 patients were included in the study. A total of 385 patients underwent unilateral and 174 underwent bilateral tissue expander/implant reconstructions, for a total of 733 reconstructions. A total complication rate of 31.8% and a major complication rate of 24.4% were calculated. The risk factors associated with a significantly increased incidence of complications were age greater than 50 years, body mass index (BMI) greater than 30, and radiation. Women younger than 50 years had a complication rate of 28.4%, whereas women older than 50 years had a complication rate of 37.0%. Women with a BMI less than 30 had a complication rate of 27.5%, whereas women with a BMI greater than 30 had a complication rate of 49%. The major complication rate in nonradiated and radiated patients was 21.2% and 45.4%, respectively. Despite higher complication rates, tissue expander/implant reconstructions were successful in 70.1% of radiated patients. Based on this study, the ideal radiated patient would have a BMI less than 30 and be younger than 50 years of age to maximize the likelihood of a successful tissue expander/implant reconstruction.
放射治疗已被证明会增加组织扩张器/植入物乳房重建的并发症发生率。本研究的目的是评估患者特征，以评估其对并发症的影响。对 2000 年 1 月至 2006 年 12 月期间接受乳房切除术加组织扩张器/植入物重建的患者进行了回顾性分析。主要观察指标是术后并发症的发生。进行了分析以确定并发症的危险因素。共纳入 560 例患者。单侧 385 例，双侧 174 例，共 733 例重建。计算出总并发症发生率为 31.8%，主要并发症发生率为 24.4%。与并发症发生率显著增加相关的危险因素是年龄大于 50 岁、体重指数（BMI）大于 30 和放射治疗。年龄小于 50 岁的女性并发症发生率为 28.4%，年龄大于 50 岁的女性并发症发生率为 37.0%。BMI 小于 30 的女性并发症发生率为 27.5%，而 BMI 大于 30 的女性并发症发生率为 49%。未接受放射治疗和接受放射治疗的患者的主要并发症发生率分别为 21.2%和 45.4%。尽管并发症发生率较高，但在 70.1%的放射治疗患者中，组织扩张器/植入物重建仍然成功。基于本研究，理想的放射治疗患者的 BMI 应小于 30，年龄应小于 50 岁，以最大限度地提高组织扩张器/植入物重建成功的可能性。
