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Erschienen in: Annals of Surgical Oncology 12/2016

27.07.2016 | Reconstructive Oncology

Postmastectomy Reconstruction Outcomes After Intraoperative Evaluation with Indocyanine Green Angiography Versus Clinical Assessment

verfasst von: Gustave K. Diep, BS, Jane Yuet Ching Hui, MD, MS, Schelomo Marmor, PhD, MPH, Bruce L. Cunningham, MD, Umar Choudry, MD, Pamela R. Portschy, MD, Todd M. Tuttle, MD, MS

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2016

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Abstract

Background

Mastectomy flap necrosis is a major complication in patients undergoing tissue expander-based reconstruction. This study compared the complication rates following mastectomy and immediate reconstruction with intraoperative indocyanine green (ICG) angiography evaluation to those with clinical assessment only.

Methods

We performed a single-institution retrospective study of mastectomy patients who underwent immediate tissue expander-based reconstruction between September 2009 and December 2013. ICG angiography was adopted in March 2012. The rates of complications in the ICG and clinical assessment only groups were compared. Factors associated with complications were identified with the Fischer exact test and univariate analysis.

Results

A total of 114 patients were identified; clinical assessment only, 53 patients; ICG angiography, 61 patients. The overall complication rates were not significantly different between the two groups (ICG angiography, 50.8 %; clinical assessment, 43.4 %; p = 0.46). There was no significant difference in the rates of unexpected return to the operating room, cellulitis, hematomas, and seromas. The overall rates of flap necrosis were not significantly different (ICG angiography, 27.9 %; clinical assessment, 18.9 %; p = 0.28). However, the rates of severe flap necrosis were significantly lower with intraoperative ICG angiography (4.9 %) than with clinical assessment only (18.9 %, p = 0.02). On univariate analysis, breast weight (≥500 g) was significantly associated with increased rates of severe flap necrosis (p = 0.04), whereas body mass index, age, smoking status, prior breast surgery, history of radiation therapy, and receipt of nipple-sparing mastectomy were not.

Conclusions

We observed that the implementation of intraoperative ICG angiography was associated with a significant decrease in the rate of severe flap necrosis.
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Metadaten
Titel
Postmastectomy Reconstruction Outcomes After Intraoperative Evaluation with Indocyanine Green Angiography Versus Clinical Assessment
verfasst von
Gustave K. Diep, BS
Jane Yuet Ching Hui, MD, MS
Schelomo Marmor, PhD, MPH
Bruce L. Cunningham, MD
Umar Choudry, MD
Pamela R. Portschy, MD
Todd M. Tuttle, MD, MS
Publikationsdatum
27.07.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5466-y

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