Mensen, J. (Jolien) (2017) Het optreden van explantatie na directe mammareconstructie onder vrouwen die een huidsparende mastectomie hebben ondergaan :Een vergelijkende studie tussen de one- en two-stage techniek. thesis, Medicine.
Full text available on request.Abstract
Background: To date, both the one- and two-stage techniques are used as an immediate breast reconstruction after a skin sparing mastectomy, with the two-stage method considered as the standard treatment. Since, there is still no consensus which technique gives the best result or the lowest risk of complications such as implant loss, a retrospective study was conducted to compare both breast reconstruction techniques. Methods: Data were collected from the medical records of 383 women who underwent immediate breast reconstruction by means of the one- or two-stage method during 2010-2016 in Medical Spectrum Twente or Isala hospital. Explantation of an implant after breast reconstruction was the primary outcome of interest. Univariate and multiple regression statistics were executed to compare the two techniques. Results: Among the total number of women the explantation rate was higher among the women with a one-stage breast reconstruction, but this was not statistically significantly different (19.6% versus 14.1%, p= 0,279). After stratification for the indication for mastectomy, the one-stage technique appeared to be associated with a statistically signigicantly higher risk of explantation among women who underwent immediate breast reconstruction after prophylactic surgery (OR Multivariate, 5,356; 95% BI, 1,154- 24,850, p= 0,032). This effect was not found among women who had their reconstruction following breast cancer surgery. The number of cosmetic corrections were similar between the samples. Additional cost analysis showed that health care costs were lower for the one-stage method than for the two-stage method. Conclusions: Overall, no significant difference in the explantation rates was found after comparing the one- and two-stage reconstruction technique. However, presymptomatic high-risk women who have to decide on a prophylactic mastectomy should be aware of a higher risk of loss of their implants after breast reconstruction when choosing the one-stage technique.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and J.H. van Uchelen, Plastisch Chirurg and Instelling: Isala, te Zwolle and Afdeling: Plastische chirurgie and Statistische begeleider: and Brohet, dr. R.M. and Genetisch Epidemioloog, statisticus |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:38 |
| Last Modified: | 25 Jun 2020 10:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/4 |
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