Work

Tumescence and sharp versus electrocautery dissection in minimal access mastectomy: a real-world retrospective cohort study

Year: 2025

Type: article

Abstract: Background Tumescence and sharp or electrocautery techniques have been employed during skin flap development in minimal access nipple-sparing mastectomy (NSM) with immediate prosthesis breast reconstruction. Our study evaluated the impact of techniques on complications after this surgery. Methods In this real-world retrospective cohort study, 5436 individuals undergoing NSM from 12 centers in China were identified. After exclusions and propensity score matching (PSM), a total of 1252 female breast cancer patients who underwent minimal access NSM with immediate prosthesis breast reconstruction between January 2016 and December 2022 were included. The effect of surgical techniques on the perioperative outcomes and postoperative complications was investigated using logistic regression analysis. The level of significance was set at P< .05. Findings After PSM, we found that patients in the tumescence and sharp dissection group (n=313) experienced significantly lower rates of necrotic complications (5.8% vs 13.0%; P=.001), infection (2.6% vs 5.6%; P=.041), implant loss (0.3% vs 2.2%; P=.025), and had shorter mean operation time (median [IQR] min, 177.0 [132.0-219.0] min, and 201.0 [143.0-249.0] min; P< .001), compared with those in the electrocautery dissection group (n=939). Interpretation Tumescence and sharp dissection might be a better option in skip flap development during minimal access NSM with immediate prosthesis breast reconstruction, in regard to operation time and surgical complications. A limitation is the variation in surgeons' skills across multiple centers. Funding National Key Research and Development Program of China (2023YFC3404500), the Natural Science Foundation of China (92057210, 82125017, 82173064, 92359302, 82322030), Science and Technology Program of Guangzhou (202103000070, 202201020479), and the New Cornerstone Science Foundation through the New Cornerstone Investigator Program and the XPLORER PRIZE.

Source: The Lancet Regional Health - Western Pacific

DOI: 10.1016/j.lanwpc.2024.101342

Authors: Yiwen Lu, Xinyu Ou, Zhihan Liu, Shicheng Su

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,250

OpenAlex ID: W4407631425

FWCI:

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