Flores Tonatiuh, Jaklin Florian J, Rohrbacher Alexander, Schrögendorfer Klaus F, Bergmeister Konstantin D
Department of Plastic Surgery, University Hospital of St. Poelten, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria.
Clinical Department of Plastic, Aesthetic and Reconstructive Surgery, University Clinic of St. Poelten, 3100 St. Poelten, Austria.
J Clin Med. 2022 Feb 3;11(3):808. doi: 10.3390/jcm11030808.
Surgical breast reconstruction is an integral part of cancer treatment but must not compromise oncological safety. Patient-dependent risk factors (smoking, BMI, etc.) are said to influence perioperative outcomes and have often been investigated. Here, we analyzed independent perioperative risk factors for increased postoperative blood loss or drainage fluid volume loss and their possible impact.
Patients undergoing breast reconstructions after breast cancer with either tissue expanders, definitive breast implants, or autologous breast reconstruction were analyzed. The collected data on patients' characteristics, blood, and drainage fluid loss were correlated and statistically investigated.
Traditional patient-dependent risk factors did not influence blood loss or drainage volumes. On the contrary, patients with preoperative anemia had significantly higher drainage outputs compared to non-anemic patients (U = 2448.5; = 0.0012). The administration of low molecular weight heparin showed a tendency of increased drainage output. Similar correlations could be seen in prolonged procedure time, all of which contributed to prolonged hospital stay (τb = 0.371; < 0.00001).
Preoperative anemia is one of the most critical factors influencing postoperative drainage fluid output. Previously assumed patient-dependent risk factors did not affect drainage output. Preoperative anemia must be monitored, and if possible, treated preoperatively to reduce postoperative morbidity.
手术乳房重建是癌症治疗的一个组成部分，但绝不能损害肿瘤学安全性。据说患者相关的风险因素（吸烟、体重指数等）会影响围手术期结果，并且经常被研究。在此，我们分析了术后失血增加或引流液量增加的独立围手术期风险因素及其可能的影响。
对接受乳腺癌手术后使用组织扩张器、确定性乳房植入物或自体乳房重建的患者进行分析。收集的关于患者特征、血液和引流液流失的数据进行了相关性分析和统计学研究。
传统的患者相关风险因素不影响失血量或引流量。相反，术前贫血患者的引流液量明显高于非贫血患者（U = 2448.5；P = 0.0012）。低分子量肝素的使用显示出引流量增加的趋势。在手术时间延长方面也观察到类似的相关性，所有这些都导致住院时间延长（τb = 0.371；P < 0.00001）。
术前贫血是影响术后引流液量的最关键因素之一。先前假定的患者相关风险因素不影响引流量。必须监测术前贫血情况，如有可能，术前进行治疗以降低术后发病率。
