Abstract:
Objective To analyze the effects of one-and two-step breast reconstruction on patient reported outcomes and complications.
Methods A total of 98 patients who underwent immediate breast reconstruction after total mastectomy from March 2017 to March 2022 were selected and divided into two groups according to different reconstruction methods：the one-step group received 50 cases of immediate prosthesis implantation reconstruction surgery，and the two-step group received 48 cases of immediate dilator-delayed prosthesis implantation reconstruction surgery. SPSS 21.0 software was used to analyze the data，and the count data were compared by line χ2 test or Fisher exact test. Measurement data were represented by（
±
s），and
t test was performed for comparison between groups. Multivariate regression analysis of postoperative complications and patient-reported outcomes was performed using linear mixed effects regression model.
P<0.05 was considered statistically significant.
Results The incidence of seroma and poor wound healing in one-step group was higher than that in two-step group，and the incidence of capsular contracture was lower than that in two-step group（P<0.05）. The number of Clavien-Dindo grade Ⅲ cases in one-step group was higher than that in two-step group（P<0.05）. The levels of postoperative social mental health，breast satisfaction and surgical outcome satisfaction in one-step group were lower than those in two-step group（P<0.05）. The results of linear mixed effects regression model showed that the poor wound healing was related to the surgical method and the use of mesh（P=0.043，0.033）. Capsular contracture and seroma were related to radiotherapy and mesh use（P=0.041，0.036）. Social psychological health and breast satisfaction were correlated with surgical methods（P=0.024，0.001）. The satisfaction of surgical outcome was related to postoperative radiotherapy and lymph node status（P=0.017，0.039）.
Conclusions Compared with one-step breast reconstruction，two-step method can reduce the incidence of poor incision healing，lower complication grade，and has more advantages in improving patients' postoperative social psychological satisfaction and breast satisfaction.
Key words:
Breast Reconstruction,
Prosthesis Implantation,
Expander,
Postoperative Complications,
Patient Reported Outcome Measures
Yongguo Fan, Yonggang Lyu, Xiaomin Yang, Huxia Wang, Nan Chen, Sai He, Yanni Hou, Jing Zhao, Jingyuan Zhang, Pihua Han. Analysis of outcomes and complications reported by patients undergoing breast reconstruction with different protocols[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(03): 262-266.