Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Sci Rep. 2022 Jan 24;12(1):1258. doi: 10.1038/s41598-022-05185-z.
This study retrospectively studied the incidence of chronic post-surgical pain (CPSP) following single-stage implant-based breast reconstruction (IBBR) and evaluated the possible risk factors. This was a retrospective cohort study, involving all patients undergoing single-stage IBBR between January and December 2019. The follow-up was completed between January and March 2021. The scores for satisfaction (SS) were based on the BREAST-Q, while the pain burden index (PBI) was used to assess the degree of CPSP. The questionnaires were completed by 159 patients. CPSP occurred in 48.43% of the patients, 2.52% of them being severe cases. Significant predictors for the development of CPSP in the univariate analysis included severe acute postoperative pain (PP), a history of preoperative chronic pain, psychological disorders, SS with the reconstructed breasts, and whether there were any regrets about having had the reconstruction. Multivariate analysis identified severe acute PP (odds ratio (OR) = 2.80, 95% confidence interval (CI) = 1.16-6.79, p = 0.023), a history of preoperative chronic pain (OR = 3.39, 95% CI = 1.42-8.10, p = 0.006), and the SS (OR = 0.86, 95% CI = 0.75-0.99, p = 0.034) as being independently associated with the development of CPSP. In subgroup analysis, the PBI of the patients in the SS < 12 group (p < 0.001), the bilateral group (p < 0.01), and the severe acute PP group (p < 0.005) was significantly higher than the PBI of those in the control groups. This study demonstrated a significant incidence of CPSP following single-stage IBBR, and the patients with lower SS of their reconstructed breasts developed more CPSP. Lower SS, bilateral procedures, and severe acute PP were predictors of higher PBI.Trial registration: Registered in Chictr.org.cn registry system on 24 February 2020 (ChiCTR2000030139).
本研究回顾性研究了一期假体乳房重建(IBBR)后慢性术后疼痛(CPSP)的发生率,并评估了可能的危险因素。这是一项回顾性队列研究,纳入了 2019 年 1 月至 12 月期间接受一期 IBBR 的所有患者。随访于 2021 年 1 月至 3 月完成。满意度评分(SS)基于 BREAST-Q,而疼痛负担指数(PBI)用于评估 CPSP 的程度。159 例患者完成了问卷调查。48.43%的患者发生了 CPSP,其中 2.52%为重度病例。单因素分析中,CPSP 发生的显著预测因素包括严重急性术后疼痛(PP)、术前慢性疼痛史、心理障碍、对重建乳房的 SS 以及对重建是否有任何遗憾。多因素分析确定严重急性 PP(比值比(OR)=2.80,95%置信区间(CI)=1.16-6.79,p=0.023)、术前慢性疼痛史(OR=3.39,95%CI=1.42-8.10,p=0.006)和 SS(OR=0.86,95%CI=0.75-0.99,p=0.034)与 CPSP 的发生独立相关。亚组分析显示,SS<12 组(p<0.001)、双侧组(p<0.01)和严重急性 PP 组(p<0.005)的患者 PBI 明显高于对照组。本研究表明一期 IBBR 后 CPSP 的发生率较高,对重建乳房 SS 较低的患者发生 CPSP 的可能性更大。较低的 SS、双侧手术和严重急性 PP 是 PBI 较高的预测因素。试验注册:2020 年 2 月 24 日在中国临床试验注册中心注册(ChiCTR2000030139)。