Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
Department of Surgery, Division of Plastic and Reconstructive Surgery, NorthShore University HealthSystem, Northbrook, Illinois, USA.
J Surg Oncol. 2024 Feb;129(2):201-207. doi: 10.1002/jso.27491. Epub 2023 Oct 23.
Patients undergoing breast reconstruction following mastectomy are often admitted overnight. In 2020, our institution implemented a protocol change to discharge clinically stable patients immediately. In this study, we examine the safety of same-day discharge following mastectomy and reconstruction.
Our retrospective study included female adults undergoing mastectomy and immediate alloplastic reconstruction from August 2019 to January 2020, before implementation of the same-day discharge protocol, and from March 2020 to September 2021, after the protocol implementation. Independent t-test and chi-square analysis was conducted to examine statistical differences.
Two hundred and eighty-five patients were included. Forty-two patients underwent reconstruction before the protocol change (Group 1) and 243 patients underwent reconstruction after the protocol change (Group 2). Group 2 had a greater percentage of prepectoral implant placement. There was no difference in demographics, complications, readmission, or reoperation. Within Group 2, 157 patients were discharged the same day (Group 2a) and 88 patients required overnight admission (Group 2b). Group 2b had higher body mass index, higher percentage of bilateral mastectomy, and larger mastectomy weights. Despite no differences in complications, Group 2b exhibited higher rates of requiring intravenous antibiotics and reoperation.
Patients may be safely discharged the same day following mastectomy and alloplastic reconstruction without an increase in complications.
接受乳房重建术的乳房切除术患者通常需要住院过夜。2020 年，我院实施了一项协议变更，即将临床稳定的患者立即出院。在这项研究中，我们检查了乳房切除和重建后当天出院的安全性。
我们的回顾性研究包括 2019 年 8 月至 2020 年 1 月期间实施当天出院协议之前接受乳房切除术和即刻全假体重建的成年女性，以及 2020 年 3 月至 2021 年 9 月期间实施协议之后接受该手术的女性。采用独立 t 检验和卡方分析进行统计学差异检验。
共纳入 285 例患者。42 例患者在协议变更前接受了重建（组 1），243 例患者在协议变更后接受了重建（组 2）。组 2 中前入路假体放置的比例更高。两组在人口统计学、并发症、再入院或再次手术方面无差异。在组 2 中，157 例患者当天出院（组 2a），88 例患者需要住院过夜（组 2b）。组 2b 的体重指数更高，双侧乳房切除术的比例更高，乳房切除术的重量更大。尽管并发症无差异，但组 2b 需要静脉用抗生素和再次手术的比例更高。
在乳房切除术和全假体重建后，患者可以安全地当天出院，而不会增加并发症。
