Winter Raimund, Haug Isabella, Lebo Patricia, Grohmann Martin, Reischies Frederike M J, Cambiaso-Daniel Janos, Tuca Alexandru, Rienmüller Theresa, Friedl Herwig, Spendel Stephan, Forbes Abigail A, Wurzer Paul, Kamolz Lars-P
Division of Plastic, Aesthetic, and Reconstructive Surgery, Medical University of Graz, Graz, Austria.
Division of Plastic, Aesthetic, and Reconstructive Surgery, Medical University of Graz, Graz, Austria.
Surgery. 2017 May;161(5):1430-1435. doi: 10.1016/j.surg.2016.11.028. Epub 2016 Dec 30.
Published complication rates for breast reduction surgery, also known as reduction mammaplasty, vary between 4% and 54%. This wide range of complication rates could be attributable to the lack of a standardized classification of complications in plastic surgery. The aim of this study was to analyze our single-center complication rates after reduction mammaplasty using the Clavien-Dindo classification.
We performed a retrospective chart review studying 804 patients between the ages of 18 and 81 years old who underwent breast reduction between 2005 and 2015 at our institution. Patients with a history of breast cancer, a previous breast operation, who did not undergo bilateral reduction mammaplasty, or who required systemic immunodeficiency/immunosuppressive drugs were excluded from our analysis. Complications were classified according to the Clavien-Dindo classification from Grades I to V.
A total of 486 patients met the inclusion criteria for the analysis. Patients had an age (mean ± standard deviation) of 39 ± 13 years and a body mass index of 26 ± 4 kg/m. Median follow-up was 274 days (interquartile range: 90.5-378). The overall rate of complications of reduction mammaplasty was 63%, with the majority of those being Grades I (48%) and II (9%), comprising 92% of all the complications. Operative revisions were required in 6% (1% Grade IIIA and 5% Grade IIIB). There were no complications graded in categories IV and V.
Although complications occurred in more than half of the cases, the majority did not require operative reintervention. The Clavien-Dindo classification can classify the severity of complications and serve as a benchmark to compare complication rates between different practices. We believe that grading of complications should distinguish between those that do and do not require operative reinterventions.
乳房缩小手术（又称缩乳术）已公布的并发症发生率在4%至54%之间。如此广泛的并发症发生率差异可能归因于整形外科缺乏标准化的并发症分类。本研究的目的是使用Clavien-Dindo分类法分析我们单中心缩乳术后的并发症发生率。
我们进行了一项回顾性病历审查，研究了2005年至2015年期间在我们机构接受乳房缩小手术的804例年龄在18至81岁之间的患者。有乳腺癌病史、既往有乳房手术史、未接受双侧缩乳术或需要全身免疫缺陷/免疫抑制药物的患者被排除在我们的分析之外。并发症根据Clavien-Dindo分类法分为I至V级。
共有486例患者符合分析的纳入标准。患者年龄（均值±标准差）为39±13岁，体重指数为26±4kg/m²。中位随访时间为274天（四分位间距：90.5 - 378）。缩乳术的总体并发症发生率为63%，其中大多数为I级（48%）和II级（9%），占所有并发症的92%。6%的患者需要进行手术修正（1%为IIIA级，5%为IIIB级）。没有IV级和V级并发症。
虽然超过一半的病例发生了并发症，但大多数并发症不需要手术再次干预。Clavien-Dindo分类法可以对并发症的严重程度进行分类，并作为比较不同医疗实践中并发症发生率的基准。我们认为，并发症的分级应区分需要和不需要手术再次干预的情况。
