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同期妇科手术是否会影响基于植入物的乳房重建术后的感染并发症发生率?

Does concurrent gynaecological surgery affect infectious complications rate after mastectomy with implant-based reconstruction?

机构信息

Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

出版信息

Radiol Oncol. 2022 Jul 20;57(1):80-85. doi: 10.2478/raon-2022-0026. eCollection 2023 Mar 1.

Abstract

BACKGROUND

Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious complications rate after mastectomy with implant-based reconstruction in patients with and without concurrent gynaecological procedure.

PATIENTS AND METHODS

We retrospectively reviewed clinical records of 159 consecutively operated patients after mastectomy with implant-based reconstruction. The patients were divided in 2 groups: 102 patients without (Group1) and 57 with (Group 2) concurrent gynaecological procedure. Infectious complications rates between the groups were compared using χ-test. Logistic regression was performed to test for association of different variables with infectious complications.

RESULTS

There were 240 breast reconstructions performed. Median follow-up time was 297 days (10-1061 days). Mean patient age was 47.2 years (95% CI 32.8-65.9); 48.2 years (95% CI 46.1-50.3) in Group 1 and 45.8 years (95% CI 43.2-48.3) in Group 2; p = 0.002). Infectious complications rate was 17.6% (17.6% . 17.5%, p = 0.987), implant loss occurred in 5.7% (4.9% . 7.0%, p = 0.58). Obesity (body mass index [BMI] > 30 kg/m), age, previous breast conserving treatment (BCT) with radiotherapy (RT) were identified as risk factors for infectious complications in univariate analysis. Obesity (adjusted odds ratio [aOR] 3.319, 95% CI 1.085-10.157, p = 0.036) and BCT with RT (aOR 7.481, 95% CI 2.230-25.101, p = 0.001) were independently associated with infectious complications in multivariate model.

CONCLUSIONS

Concurrent gynaecological procedure for patients undergoing mastectomy with implant-based reconstruction did not carry an increased risk for infectious complications.

摘要

背景

接受乳腺癌手术的女性通常需要进行妇科手术。我们的研究目的是比较接受乳房切除术和基于植入物的重建术的患者中,同时进行妇科手术与不进行妇科手术的感染并发症发生率。

患者和方法

我们回顾性分析了 159 例连续接受乳房切除术和基于植入物的重建术的患者的临床记录。患者分为两组:102 例无(组 1)和 57 例有(组 2)同时进行妇科手术。使用卡方检验比较两组之间的感染并发症发生率。使用逻辑回归检验不同变量与感染并发症的相关性。

结果

共进行了 240 例乳房重建术。中位随访时间为 297 天(10-1061 天)。平均患者年龄为 47.2 岁(95%CI 32.8-65.9);组 1 为 48.2 岁(95%CI 46.1-50.3),组 2 为 45.8 岁(95%CI 43.2-48.3);p = 0.002)。感染并发症发生率为 17.6%(17.5%. 17.6%,p = 0.987),植入物丢失发生率为 5.7%(4.9%. 7.0%,p = 0.58)。肥胖(体重指数[BMI] > 30 kg/m)、年龄、先前接受保乳治疗(BCT)伴放疗(RT)被确定为单因素分析中感染并发症的危险因素。肥胖(调整后比值比[aOR] 3.319,95%CI 1.085-10.157,p = 0.036)和 BCT 伴 RT(aOR 7.481,95%CI 2.230-25.101,p = 0.001)在多变量模型中与感染并发症独立相关。

结论

接受乳房切除术和基于植入物的重建术的患者同时进行妇科手术不会增加感染并发症的风险。

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