Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Breast Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Surg Oncol. 2023 Oct;128(5):726-742. doi: 10.1002/jso.27378. Epub 2023 Jul 5.
The effects of COVID-19 on breast reconstruction included shifts toward alloplastic reconstruction methods to preserve hospital resources and minimize COVID exposures. We examined the effects of COVID-19 on breast reconstruction hospital length of stay (LOS) and subsequent early postoperative complication rates.
Using the National Surgical Quality Improvement Program, we examined female patients who underwent mastectomy with immediate breast reconstruction from 2019 to 2020. We compared postoperative complications across 2019-2020 for alloplastic and autologous reconstruction patients. We further performed subanalysis of 2020 patients based on LOS.
Both alloplastic and autologous reconstruction patients had shorter inpatient stays. Regarding the alloplastic 2019 versus 2020 cohorts, complication rates did not differ (p > 0.05 in all cases). Alloplastic patients in 2020 with longer LOS had more unplanned reoperations (p < 0.001). Regarding autologous patients in 2019 versus 2020, the only complication increasing from 2019 to 2020 was deep surgical site infection (SSI) (2.0% vs. 3.6%, p = 0.024). Autologous patients in 2020 with longer LOS had more unplanned reoperations (p = 0.007).
In 2020, hospital LOS decreased for all breast reconstruction patients with no complication differences in alloplastic patients and a slight increase in SSIs in autologous patients. Shorter LOS may lead to improved satisfaction and lower healthcare costs with low complication risk, and future research should examine the potential relationship between LOS and these outcomes.
COVID-19 对乳房重建的影响包括转向使用假体重建方法，以节省医院资源并尽量减少 COVID 暴露。我们研究了 COVID-19 对乳房重建住院时间（LOS）和随后早期术后并发症发生率的影响。
使用国家手术质量改进计划，我们检查了 2019 年至 2020 年接受乳房切除术和即刻乳房重建的女性患者。我们比较了 2019-2020 年所有整形和自体重建患者的术后并发症。我们进一步根据 LOS 对 2020 年的患者进行了亚分析。
假体和自体重建患者的住院时间都缩短了。在 2019 年与 2020 年的假体患者中，并发症发生率没有差异（在所有情况下，p>0.05）。2020 年 LOS 较长的假体患者计划外再次手术更多（p<0.001）。对于 2019 年与 2020 年的自体患者，唯一从 2019 年到 2020 年增加的并发症是深部手术部位感染（SSI）（2.0%比 3.6%，p=0.024）。2020 年 LOS 较长的自体患者计划外再次手术更多（p=0.007）。
在 2020 年，所有乳房重建患者的住院时间都缩短了，假体患者的并发症没有差异，自体患者的 SSI 略有增加。较短的 LOS 可能会提高满意度并降低医疗保健成本，同时并发症风险较低，未来的研究应检查 LOS 与这些结果之间的潜在关系。
