Your browser doesn't support javascript.
loading
Trends in outcomes with adoption of indocyanine green angiography in postmastectomy reconstruction.
Nguyen, Chu Luan; Comerford, Alexander Peter; Dayaratna, Nirmal; Lata, Tahmina; Paredes, Steven Ronald; Easwaralingam, Neshanth; Seah, Jue Li; Azimi, Farhad; Mak, Cindy; Pulitano, Carlo; Warrier, Sanjay Kumar.
Afiliação
  • Nguyen CL; Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
  • Comerford AP; Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
  • Dayaratna N; Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
  • Lata T; Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
  • Paredes SR; Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
  • Easwaralingam N; Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
  • Seah JL; Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
  • Azimi F; Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
  • Mak C; Department of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
  • Pulitano C; Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
  • Warrier SK; Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
ANZ J Surg ; 93(1-2): 270-275, 2023 01.
Article em En | MEDLINE | ID: mdl-36576103
BACKGROUND: Indocyanine green angiography (ICGA) aims to reduce ischaemic complications by supplementing intraoperative perfusion assessment of mastectomy flaps. Learning curves for this technology have not been analysed. We evaluated changes in patient outcomes with increasing case volume after ICGA adoption in postmastectomy reconstruction. METHODS: Single-institution retrospective analysis of 320 implant-based reconstructions following mastectomy using ICGA from 2015, when it was introduced, to 2021. Cases chronologically divided into tertiles and complications amongst groups evaluated. Trends in ischaemic complications plotted using weighted moving average. CUSUM analysis determined after how many cases plateau was reached. Number of ischaemic complications prior to plateau calculated with AUC analysis. RESULTS: Ischaemic complications decreased over time (Group 1, 15.1%; Group 2, 11.2%; Group 3, 4.7%, P = 0.034). Cases of delayed reconstruction increased over time (Group 1, 6.6%; Group 2, 28%; Group 3, 22.4%; P < 0.001). Our institution reached plateau of 10% ischaemic complications after 160 cases. Mean incidence of ischaemic complications decreased from 16.9% during the first 160 cases to 3.8% after plateau was reached (P < 0.001). Eleven extra breasts (6.9%) experienced ischaemic complications, that may have been avoided if operated by surgeons after the first 160 cases. CONCLUSIONS: There was increased tendency towards a conservative approach of delaying reconstruction and decreased rates of ischaemic complications with increasing case volume after ICGA implementation. A significant number of cases were needed to reach plateau of minimal ischaemic complications. This data could encourage development of standardized protocols for this technology to shorten learning curves for improved patient outcomes.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamoplastia Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamoplastia Idioma: En Ano de publicação: 2023 Tipo de documento: Article