مجله جهانی جراحی پلاستیک
مجله جهانی جراحی پلاستیک
پنجشنبه 30 مهر 1405
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دوره 15، شماره 2 - ( 1405 )
جلد 15 شماره 2 صفحات 53-46 |
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Masoomi H, P. Colton B. Is Advanced Age A Contraindication for Free Flap Breast Reconstruction?. WJPS 2026; 15 (2) :46-53
URL: http://wjps.ir/article-1-1669-fa.html
URL: http://wjps.ir/article-1-1669-fa.html
Is Advanced Age A Contraindication for Free Flap Breast Reconstruction?. مجله جهانی جراحی پلاستیک. 1405; 15 (2) :46-53
چکیده: (681 مشاهده)
Background: Understanding the relationship between age and perioperative outcomes in free flap-based breast reconstruction, is critical. We aimed to evaluate the older age as an independent risk factor for perioperative complications following free flap-based breast reconstruction surgery.
Methods: This retrospective study utilized data from the National Surgical Quality Improvement Program (NSQIP) database from 2016 to 2022. The study included breast cancer patients who underwent free flap breast reconstruction surgery, divided into two groups: those aged ≤65 years and those aged >65 years.
Results: The study sample comprised 15,364 patients, with 1,447 (9.4%) aged >65 years. The overall complication rate was 14.1% for patients >65 years compared to 12.4% for patients ≤65 years, though this difference was not statistically significant (P=0.068). Similarly, there was no significant difference in unplanned return back to the operating room (OR: 10.7% vs. 11.3%; P=0.068) and unplanned readmission rate (6.5% vs. 5.5%; P=0.530) in patients>65 years old compared with patient<65 years old. Additionally, multivariate regression analyses showed that age >65 was not an independent risk factor for overall complication rate (adjusted odd’s ratio [AOR] 1.10), unplanned return to OR (AOR 0.92), and readmission (AOR 1.14).
Conclusion: Elderly patients who underwent free flap breast reconstruction had comparable perioperative outcomes with the younger patients. The decision to proceed with this surgery should be based on a comprehensive assessment of the patient's overall health status rather than age alone. Free-flap breast reconstruction should be considered in patients at any age as long as other indications for surgery are met.
Methods: This retrospective study utilized data from the National Surgical Quality Improvement Program (NSQIP) database from 2016 to 2022. The study included breast cancer patients who underwent free flap breast reconstruction surgery, divided into two groups: those aged ≤65 years and those aged >65 years.
Results: The study sample comprised 15,364 patients, with 1,447 (9.4%) aged >65 years. The overall complication rate was 14.1% for patients >65 years compared to 12.4% for patients ≤65 years, though this difference was not statistically significant (P=0.068). Similarly, there was no significant difference in unplanned return back to the operating room (OR: 10.7% vs. 11.3%; P=0.068) and unplanned readmission rate (6.5% vs. 5.5%; P=0.530) in patients>65 years old compared with patient<65 years old. Additionally, multivariate regression analyses showed that age >65 was not an independent risk factor for overall complication rate (adjusted odd’s ratio [AOR] 1.10), unplanned return to OR (AOR 0.92), and readmission (AOR 1.14).
Conclusion: Elderly patients who underwent free flap breast reconstruction had comparable perioperative outcomes with the younger patients. The decision to proceed with this surgery should be based on a comprehensive assessment of the patient's overall health status rather than age alone. Free-flap breast reconstruction should be considered in patients at any age as long as other indications for surgery are met.
فهرست منابع
1. Butz DR, Lapin B, Yao K, et al. Advanced age is a predictor of 30-day complications after autologous but not implant-based postmastectomy breast reconstruction. Plast Reconstr Surg 2015;135(2):253e-261e. doi:10.1097/PRS.0000000000000988 [DOI:10.1097/PRS.0000000000000988]
2. Torabi R, Stalder MW, Tessler O, et al. Assessing Age as a Risk Factor for Complications in Autologous Breast Reconstruction. Plast Reconstr Surg 2018;142(6):840e. doi:10.1097/PRS.0000000000004990 [DOI:10.1097/PRS.0000000000004990]
3. Walton L, Ommen K, Audisio RA. Breast reconstruction in elderly women with breast cancer: A review. Cancer Treat Rev 2011;37(5):353-357. doi:10.1016/j.ctrv.2011.02.001 [DOI:10.1016/j.ctrv.2011.02.001]
4. Selber JC, Bergey M, Sonnad SS, et al. Free Flap Breast Reconstruction in Advanced Age: Is It Safe? Plast Reconstr Surg 2009;124(4):1015-1022. doi:10.1097/PRS.0b013e3181b453fd [DOI:10.1097/PRS.0b013e3181b453fd]
5. Heikkinen V, Myllyoja K, Seppänen M, Kuokkanen H. Efficacy of breast reconstruction in elderly women (>60 years) using DIEP flaps: a comparative study. J Plast Reconstr Aesthet Surg 2023;84:266-272. doi:10.1016/j.bjps.2022.12.023 [DOI:10.1016/j.bjps.2023.05.022]
6. Santosa KB, Qi J, Kim HM, et al. Effect of patient age on outcomes in breast reconstruction: results from a multicenter prospective study. J Am Coll Surg 2016;223(6):745-754. doi:10.1016/j.jamcollsurg2016.08.014 [DOI:10.1016/j.jamcollsurg.2016.09.003]
7. Ludolph I, Arkudas A, Schmitz M, et al. Is there a rationale for autologous breast reconstruction in older patients? A retrospective single center analysis of QoL, complications and comorbidities after DIEP or ms-TRAM flap using the BREAST-Q. Breast J 2015;21(6):588-595. doi:10.1111/tbj.12558 [DOI:10.1111/tbj.12558]
8. Masoomi H, Paydar KZ, Wirth GA, et al. Predictive risk factors of venous thromboembolism in autologous breast reconstruction surgery. Ann Plast Surg 2014;72(1):30-33. doi:10.1097/SAP.0000000000000003 [DOI:10.1097/SAP.0000000000000003]
9. Baban CK, Devane L, Geraghty J. Change of paradigm in treating elderly with breast cancer: are we undertreating elderly patients? Ir J Med Sci 2019;188(2):379-388. doi:10.1007/s11845-018-1851-9 [DOI:10.1007/s11845-018-1851-9]
10. Konoeda H, Yamaki T, Hamahata A, et al. Incidence of deep vein thrombosis in patients undergoing breast reconstruction with autologous tissue transfer. Phlebology 2017;32(4):282-288. doi:10.1177/0268355516680427 [DOI:10.1177/0268355516680427]
11. Chicco D, Lodigiani L, Bellato E, et al. Outcomes of free flap breast reconstruction in patients aged ≥70 years: a single-centre experience. J Plast Reconstr Aesthet Surg 2024;99:352-358. doi:10.1016/j.bjps.2023.11.008 [DOI:10.1016/j.bjps.2023.11.008]
12. Dejean C, Facy O, Schuster C, et al. DIEP free flap in elderly women for breast reconstruction: experience of a tertiary center and literature review. Breast J 2021;27(9):700-705. doi:10.1111/tbj.14287 [DOI:10.1111/tbj.14287]
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