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Two-Stage Implant-Based Breast Reconstruction Using Intraoperative Fluorescence Imaging: A Propensity Score-Matched Analysis.
- Source :
-
Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Feb 01; Vol. 153 (2), pp. 291-303. Date of Electronic Publication: 2023 Apr 26. - Publication Year :
- 2024
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Abstract
- Background: Limited comparability between study groups can generate significant selection and observer bias when evaluating the efficacy of the SPY system and fluorescence imaging for implant-based breast reconstruction. In this study, the authors compared the surgical outcomes and complications during the first stage of reconstruction between reconstructions evaluated intraoperatively with fluorescence imaging using the SPY system and clinical assessment using a matched analysis.<br />Methods: The authors conducted a retrospective review of patients undergoing total mastectomy and immediate two-stage implant-based breast reconstruction with TEs from January of 2011 to December of 2020. The rate of complication, time for TE-to-implant exchange, and time to start radiotherapy were compared between groups (intraoperative fluorescence imaging versus clinical assessment) using a propensity score-matched analysis.<br />Results: After propensity score matching, 198 reconstructions were evaluated. There were 99 reconstructions in each group. The median time for TE-to-implant exchange (140 days versus 185 days; P = 0.476) and time to initiate adjuvant radiotherapy (144 days versus 98 days; P = 0.199) were comparable between groups. The 30-day rate of wound-related complications (21% versus 9%; P = 0.017) and 30-day rate of wound-related unplanned interventions were significantly higher in reconstructions evaluated with clinical assessment when compared with the SPY system (16% versus 5%; P = 0.011). A higher 30-day rate of seroma (19% versus 14%; P = 0.041) and hematoma (8% versus 0%; P = 0.004) were found in reconstructions assessed intraoperatively with the SPY system.<br />Conclusions: After matching, reconstructions evaluated with fluorescence imaging exhibited a lower incidence of early wound-related complications when compared with clinical evaluation alone. Nonetheless, the Wise pattern for mastectomy was found to be the only independent predictor associated with early wound-related complications.<br />Clinical Question/level of Evidence: Therapeutic, III.<br /> (Copyright © 2023 by the American Society of Plastic Surgeons.)
- Subjects :
- Humans
Female
Mastectomy adverse effects
Postoperative Complications epidemiology
Postoperative Complications etiology
Propensity Score
Retrospective Studies
Breast Neoplasms diagnostic imaging
Breast Neoplasms surgery
Breast Neoplasms complications
Mammaplasty adverse effects
Mammaplasty methods
Breast Implants adverse effects
Breast Implantation adverse effects
Breast Implantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1529-4242
- Volume :
- 153
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Plastic and reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 37104496
- Full Text :
- https://doi.org/10.1097/PRS.0000000000010602