From the Division of Plastic and Reconstructive Surgery, Department of Surgery.
Statistics and Epidemiology and Research Designs, Clinical and Translational Science Center, University of New Mexico, Health Sciences Center.
Ann Plast Surg. 2021 Nov 1;87(5):493-500. doi: 10.1097/SAP.0000000000003022.
The safety of combined augmentation-mastopexy is controversial. This study evaluates a national database to analyze the perioperative safety of combined augmentation-mastopexy to either augmentation or mastopexy alone.
The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients undergoing augmentation mammaplasty and mastopexy from 2005 to 2018. The patients were divided into the following groups: group I, augmentation; group II, mastopexy; group III, combined augmentation-mastopexy. Baseline characteristics and outcomes were compared. Outcomes were 30-day complications, reoperation, and readmission.
We found 5868 (74.2%) augmentation only, 1508 (19.1%) mastopexy only and 534 (6.6%) combined augmentation-mastopexy cases. Mean operative time was highest among the combined group at 129 minutes compared with 127 minutes for mastopexy alone and 66 minutes for augmentation alone (P < 0.01). Rates of any complications and readmission were different among groups (0.8% vs 2.5% vs 1.5% respectively, P < 0.01 and 0.7% vs 1.5% vs 1.5% respectively, P = 0.049), whereas reoperation was not statistically different (1.2% vs 1.4% vs 1.5%, P = 0.75). The incidence of dehiscence (0.6%; P < 0.01) was highest in the combined group. Multivariable logistic regression analysis did not reveal an increased odds of complications, reoperation, or readmission with combined augmentation-mastopexy.
An evaluation of the nationwide cohort suggests that combined augmentation-mastopexy is a safe procedure in the perioperative period.
乳房增大与乳房悬吊术联合应用的安全性存在争议。本研究通过分析国家数据库，评估了单纯乳房增大术、单纯乳房悬吊术与联合应用这两种术式在围手术期的安全性。
本研究在美国外科医师学会国家外科质量改进计划数据库中查询了 2005 年至 2018 年间行乳房增大成形术和乳房悬吊术的患者。将患者分为以下三组：I 组，乳房增大术；II 组，乳房悬吊术；III 组，乳房增大与乳房悬吊联合术。比较了各组的基线特征和结果。结果包括 30 天内的并发症、再次手术和再入院。
我们发现，5868 例（74.2%）为单纯乳房增大术，1508 例（19.1%）为单纯乳房悬吊术，534 例（6.6%）为乳房增大与乳房悬吊联合术。联合组的手术时间最长，为 129 分钟，与单纯乳房悬吊术的 127 分钟和单纯乳房增大术的 66 分钟相比均显著延长（P < 0.01）。各组之间的总并发症发生率和再入院率不同（0.8%比 2.5%比 1.5%，P < 0.01 和 0.7%比 1.5%比 1.5%，P = 0.049），但再次手术率无统计学差异（1.2%比 1.4%比 1.5%，P = 0.75）。联合组的切口裂开发生率最高（0.6%；P < 0.01）。多变量逻辑回归分析并未显示联合乳房增大与乳房悬吊术增加了并发症、再次手术或再入院的风险。
对全国范围内队列的评估表明，联合乳房增大与乳房悬吊术在围手术期是一种安全的手术方法。
