caa a22 4500 445339241 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1913-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1913-y Additive Risk of Tumescent Technique in Patients Undergoing Mastectomy with Immediate Reconstruction [Elektronische Daten] [Akhil Seth, Elliot Hirsch, Neil Fine, Gregory Dumanian, Thomas Mustoe, Robert Galiano, Nora Hansen, John Kim] Background: The potential advantages of tumescent mastectomy technique have been increasingly discussed within the literature. However, there is concern that tumescent solution may also affect postoperative complication rates. This study evaluates patient outcomes following tumescent mastectomy and immediate implant reconstruction. Methods: Retrospective review of 897 consecutive patients (1,217 breasts) undergoing mastectomy with immediate implant reconstruction between 4/1998 and 10/2008 at a single institution was performed. Demographic and operative factors, postoperative outcomes, and overall follow-up were recorded. Complications were categorized by type and end-outcome. Fisher's exact test, Student t-test, and multiple linear regression were used for statistical analysis. Results: Tumescent (n=332, 457 breasts) and nontumescent (n=565, 760 breasts) patients were clinically similar. Mean follow-up was 36.5months. Regression analysis demonstrated that tumescent technique increased the risk of overall complications [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.02-1.81, p=0.04]. In particular, nonoperative and operative complications (OR 1.53, 95% CI 1.04-2.26, p=0.04; OR 1.58, 95% CI 1.11-2.23, p=0.01, respectively), and the rate of major mastectomy flap necrosis (OR 1.57, 95% CI 1.05-2.35, p=0.03) were significantly affected. In patients with other, more significant risk factors, tumescent technique had an additive effect on complication rates. Additionally, the majority of tumescent breast complications (78.6%, 81/103) had at least one other significant risk factor. Conclusions: Our review demonstrates that tumescent mastectomy with immediate implant reconstruction, although possessing distinct advantages, can increase postoperative complication rates. This additive effect is particularly apparent in patients with elevated complication risk at baseline. Choice of mastectomy technique should be made with careful consideration of patient comorbidities. Society of Surgical Oncology, 2011 Seth Akhil Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Hirsch Elliot Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Fine Neil Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Dumanian Gregory Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Mustoe Thomas Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Galiano Robert Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Hansen Nora Lynn Sage Comprehensive Breast Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA aut Kim John Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3041-3046 1068-9265 18:11<3041 2011 18 10434 https://doi.org/10.1245/s10434-011-1913-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1913-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Seth Akhil Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Hirsch Elliot Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Fine Neil Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Dumanian Gregory Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Mustoe Thomas Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Galiano Robert Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 700 1- Hansen Nora Lynn Sage Comprehensive Breast Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA aut NATIONALLICENCE 700 1- Kim John Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3041-3046 1068-9265 18:11<3041 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer