Factors Associated with Anastomotic Failure after Microvascular Reconstruction of the Breast

摘要: The prevalence of anastomotic failure resulting in return to the operating room and flap necrosis after microvascular breast reconstruction ranges from I 5 percent. purpose this study was review a set factors that may be associated with occurrence. Microvascular performed 198 women January 1998 July 2002. mean age for all 47.7 years. There were 158 unilateral 41 bilateral reconstructions, total 240 flaps. specific flaps included free transverse rectus abdominis musculocutaneous (n = 176), deep inferior epigastric perforator 58), superior gluteal artery 6). Upon recognition failure, immediately returned room. Factors considered relevant choice recipient vessel, timing reconstruction, previous chest wall radiation therapy, axillary lymph node dissection, tobacco use, diabetes mellitus, patient age, hematoma. Patient follow-up ranged 59 months. Descriptive statistics, Fisher's exact test, logistic regression used analyses summarize data. Of flaps, necessary 20 (8.3 percent), occurred nine (3.8 rate salvage 55 percent (11 flaps). Venous occlusion responsible 16 returns eight failures. Statistical analysis demonstrated both significantly venous occlusion, delayed Previous dissection therapy had only weak association results demonstrate is majority cases. Age, mellitus not failure. significance related its frequent and/or perivascular fibrosis.