Single Stage Direct-to-Implant Breast Reconstruction Has Lower Complication Rates Than Tissue Expander and Implant and Comparable Rates to Autologous Reconstruction in Patients Receiving Postmastectomy Radiation

摘要: Purpose To compare single-stage direct-to-implant (DTI) immediate reconstruction to the commonly used 2-stages expander and implant (TE/I) or autologous with focus on postmastectomy radiation therapy (PMRT) setting. Methods Materials We reviewed charts of 1,286 patients who underwent 1,814 breast reconstructions at our institution without PMRT from 1997 2017. Patients were divided into 6 groups according type status. Primary objective was complications defined solely surgical reintervention operative notes such as infection, skin necrosis, fat necrosis across all groups. Implant-related capsular contracture, rupture exposure, failure compared between TE/I DTI. Kaplan–Meier estimates calculate 5-year cumulative incidence complications. The secondary 3 types in settings followed by multivariable analysis. Results Median follow-up 5.8 years. Among 1286 patients, 41.1% (N = 529/1286) received PMRT. 1814 reconstructed breasts, autologous, single-stage, represented 18.7%, 34.8%, 46.2%, respectively. With no PMRT, any complication 11.1%, 12.6%, 19.5% for DTI, reconstructions, addition resulted 15.1%, 18.2%, 36.8%, analysis showed that DTI associated lesser TE/I, whereas significant difference noted autologous. Conclusions Single-stage had significantly lower rates than not different settings. may offer a valuable option receiving