<abstract xmlns="http://www.w3.org/1999/xhtml">
<sec id="j_raon-2022-0026_s_005">
<h3>Background</h3>
<p>Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious complications rate after mastectomy with implant-based reconstruction in patients with and without concurrent gynaecological procedure.</p></sec>
<sec id="j_raon-2022-0026_s_006">
<h3>Patients and methods</h3>
<p>We retrospectively reviewed clinical records of 159 consecutively operated patients after mastectomy with implant-based reconstruction. The patients were divided in 2 groups: 102 patients without (Group1) and 57 with (Group 2) concurrent gynaecological procedure. Infectious complications rates between the groups were compared using χ<sup>2</sup>-test. Logistic regression was performed to test for association of different variables with infectious complications.</p>
</sec>
<sec id="j_raon-2022-0026_s_007">
<h3>Results</h3>
<p>There were 240 breast reconstructions performed. Median follow-up time was 297 days (10–1061 days). Mean patient age was 47.2 years (95% CI 32.8–65.9); 48.2 years (95% CI 46.1–50.3) in Group 1 and 45.8 years (95% CI 43.2–48.3) in Group 2; p = 0.002). Infectious complications rate was 17.6% (17.6% <italic>vs</italic>. 17.5%, p = 0.987), implant loss occurred in 5.7% (4.9% <italic>vs</italic>. 7.0%, p = 0.58). Obesity (body mass index [BMI] > 30 kg/m<sup>2</sup>), age, previous breast conserving treatment (BCT) with radiotherapy (RT) were identified as risk factors for infectious complications in univariate analysis. Obesity (adjusted odds ratio [aOR] 3.319, 95% CI 1.085–10.157, p = 0.036) and BCT with RT (aOR 7.481, 95% CI 2.230–25.101, p = 0.001) were independently associated with infectious complications in multivariate model.</p>
</sec>
<sec id="j_raon-2022-0026_s_008">
<h3>Conclusions</h3>
<p>Concurrent gynaecological procedure for patients undergoing mastectomy with implant-based reconstruction did not carry an increased risk for infectious complications.</p>
</sec>
</abstract>

Background
Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious complications rate after mastectomy with implant-based reconstruction in patients with and without concurrent gynaecological procedure.

Patients and methods
We retrospectively reviewed clinical records of 159 consecutively operated patients after mastectomy with implant-based reconstruction. The patients were divided in 2 groups: 102 patients without (Group1) and 57 with (Group 2) concurrent gynaecological procedure. Infectious complications rates between the groups were compared using χ2-test. Logistic regression was performed to test for association of different variables with infectious complications.


Results
There were 240 breast reconstructions performed. Median follow-up time was 297 days (10–1061 days). Mean patient age was 47.2 years (95% CI 32.8–65.9); 48.2 years (95% CI 46.1–50.3) in Group 1 and 45.8 years (95% CI 43.2–48.3) in Group 2; p = 0.002). Infectious complications rate was 17.6% (17.6% vs. 17.5%, p = 0.987), implant loss occurred in 5.7% (4.9% vs. 7.0%, p = 0.58). Obesity (body mass index [BMI] > 30 kg/m2), age, previous breast conserving treatment (BCT) with radiotherapy (RT) were identified as risk factors for infectious complications in univariate analysis. Obesity (adjusted odds ratio [aOR] 3.319, 95% CI 1.085–10.157, p = 0.036) and BCT with RT (aOR 7.481, 95% CI 2.230–25.101, p = 0.001) were independently associated with infectious complications in multivariate model.


Conclusions
Concurrent gynaecological procedure for patients undergoing mastectomy with implant-based reconstruction did not carry an increased risk for infectious complications.

Does concurrent gynaecological surgery affect infectious complications rate after mastectomy with implant-based reconstruction?

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background
Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious...

Variable	OR	P	aOR	p
Gynaecological procedure	1.116 (0.486–2.564)	0.796	NA	NA
BMI < 25	1		1
25–30	3.000 (0.974–9.239)	0.056	2.552 (0.777–8.382)	0.122
> 30	8.100 (2.540–25.826)	< 0.001	7.481 (2.230–25.101)	0.001
Age > 45	2.707 (1.118–6.552)	0.027	1.939 (0.497–3.907)	0.529
Smoking	1.061 (0.413–2.724)	0.903	NA	NA
Diabetes	2.286 (0.200-26.094)	0.506	NA	NA
ASA 1	1
2	1.821 (0.560-5.921)	0.319	NA	NA
3	0.675	0.739	NA	NA
Previous with RT BCT	(0.067-6.789) 3.802 (1.546-9.354)	0.004	3.319 (1.085–10.157)	0.036
NACT	0.345 (0.076-1.553)	0.165	NA	NA
ACT	0.995 (0.369-2.687)	0.992	NA	NA
Adj. RT	0.909 (0.338-2.442)	0.849	NA	NA

Variable	All	Group 1	Group 2	p
Variable				p
	N = 159	N = 102 (64.2%)	N = 57 (35.8%)
Age (years)	47.2 (95% CI 32.8–65,9)	48.2 (95% CI 46.1–50.3)	45.8 (95% CI 43.2–48.3)	0.002
BMI (kg/m²)	24.7 (95% CI 18.9–34,8)	24.4 (95% CI 23.4–25.4)	25.8 (95% CI 24.1–27.4)	0.189
Smoking	37 (23.3%)	22 (21.6%)	15 (26.3%)	0.497
Diabetes mellitus	3 (1.9%)	3 (2.9%)	0	0.191
ASA score				0.622
1	31 (19.5%)	24 (23.5%)	7 (12.3%)
2	80 (50.3%)	56 (54.9%)	24 (42.1%)
3	11 (6.9%)	7 (6.9%)	4 (7.0%)
Unknown	37 (23.3%)	15 (14.7%)	22 (38.6%)
Previous BCT with RT	29 (18.2%)	8 (7.8%)	21 (36.8%)	0.001
NACT	25 (15.7%)	22 (21.6%)	3 (5.3%)	0.007
Adjuvant RT	35 (22.0%)	32 (31.4%)	3 (5.3%)	0.001
ACT	33 (20.8%)	23 (22.5%)	10 (17.5%)	0.455

	All (%)	Group 1 (%)	Group 2 (%)	p-value
All*	28 (17.6)	18 (17.6)	10 (17.5)	0.987
Surgical intervention needed**	13 (8.2)	8 (7.8)	5 (8.8)	0.84
Implant loss***	9 (5.7)	5 (4.9)	4 (7.0)	0.58

Does concurrent gynaecological surgery affect infectious complications rate after mastectomy with implant-based reconstruction?

Article Category: Research Article

Data publikacji: 20 lip 2022

Zakres stron: 80 - 85

Otrzymano: 24 kwi 2022

Przyjęty: 23 maj 2022

DOI: https://doi.org/10.2478/raon-2022-0026

© 2023 Nina Pislar, Barbara Peric, Uros Ahcan, Romi Cencelj-Arnez, Janez Zgajnar, Andraz Perhavec, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Variables associated with infectious complications

Patients characteristics

Surgical site infections after implant reconstruction