乳腺癌手术的流行病学及结果
THE EPIDEMIOLOGY AND OUTCOMES OF BREAST CANCER SURGERY.
作者信息
Fraser Victoria J, Nickel Katelin B, Fox Ida K, Margenthaler Julie A, Olsen Margaret A
机构信息
ST. LOUIS, MISSOURI.
出版信息
Trans Am Clin Climatol Assoc. 2016;127:46-58.
Abstract
We studied women after breast-conserving surgery and mastectomy with immediate (IR) and delayed reconstruction to determine the risk of surgical site infections (SSIs). The SSI rate was 1.3% for BCS, 5.2% for mastectomy, and 10.3% for mastectomy plus IR with flap. SSI risk was higher for mastectomy and IR with implantation versus delayed reconstruction with implantation (8.8% versus 5.9%, = 0.039) or staged reconstruction with implantation (3.3%, <0.001). Women with SSI had more SSIs after second-staged reconstruction and implantation compared to those without SSI (10.9% versus 2.7%, <0.001). SSI was first coded 2 to 30 days postoperatively in 50.3%, and 23% between 31 and 60 days postoperatively. The noninfectious wound complication rate was 10.8%. The noninfectious wound complication rate was 5.8% after mastectomy, 13.4% after mastectomy with implantation, 18.7% after mastectomy with flap, and 15.2% with mastectomy flap and implantation ( <0.001). Implants were removed within 60 days in 6% of mastectomies with implantation.
摘要
我们研究了保乳手术及乳房切除术后即刻（IR）和延迟重建的女性患者，以确定手术部位感染（SSI）的风险。保乳手术的SSI发生率为1.3%，乳房切除术为5.2%，乳房切除加带蒂皮瓣即刻重建为10.3%。与植入物延迟重建（8.8%对5.9%，P = 0.039）或植入物分期重建（3.3%，P<0.001）相比，乳房切除术及植入物即刻重建的SSI风险更高。与无SSI的女性相比，发生SSI的女性在二期重建和植入后发生更多的SSI（10.9%对2.7%，P<0.001）。50.3%的SSI在术后2至30天首次编码，23%在术后31至60天编码。非感染性伤口并发症发生率为10.8%。乳房切除术后非感染性伤口并发症发生率为5.8%，乳房切除加植入物后为13.4%，乳房切除加带蒂皮瓣后为18.7%，乳房切除带蒂皮瓣加植入物后为15.2%（P<0.001）。6%的乳房切除加植入物患者在60天内取出了植入物。
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