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- Title
Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction.
- Authors
Houvenaeghel, Gilles; Bannier, Marie; Bouteille, Catherine; Tallet, Camille; Sabiani, Laura; Charavil, Axelle; Bertrand, Arthur; Van Troy, Aurore; Buttarelli, Max; Teyssandier, Charlène; Tallet, Agnès; de Nonneville, Alexandre; Cohen, Monique
- Abstract
Simple Summary: A rapid evolution of IBR techniques has been reported, including prepectoral implant immediate breast reconstruction (IBR) with a mesh. In a monocentric cohort, subpectoral implant IBR was performed in 529 mastectomies (62.0%) and prepectoral implant IBR in 324 (38.0%), with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR, with no significant difference for grade 2–3 complications. Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication, or with grade 2–3 complications. Prepectoral implant-IBR was associated with significantly shorter operative times. Costs above the median were significantly associated with subpectoral placement and mesh use. Prepectoral implantation can be considered a good and safe technique. However, patient selection may be necessary and we propose a complication risk score to aid decision-making. Introduction: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. Methods: We analyzed all complications and grade 2–3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR. Results: Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR (p = 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2–3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2–3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2–3 complications. Conclusions: Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique.
- Subjects
MAMMAPLASTY; COMPLICATIONS of prosthesis; BREAST tumors; TREATMENT effectiveness; TREATMENT duration; DESCRIPTIVE statistics; SURGICAL complications; MASTECTOMY; BREAST implants; LENGTH of stay in hospitals; PATIENT satisfaction; SURGICAL meshes; MEDICAL care costs; REGRESSION analysis; EVALUATION
- Publication
Cancers, 2024, Vol 16, Issue 6, p1129
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16061129