Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction
Introduction: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. Methods: We analyzed all complications and grade 2–3 complications, the implant l...
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/6/1129 |
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| author | Gilles Houvenaeghel Marie Bannier Catherine Bouteille Camille Tallet Laura Sabiani Axelle Charavil Arthur Bertrand Aurore Van Troy Max Buttarelli Charlène Teyssandier Agnès Tallet Alexandre de Nonneville Monique Cohen |
| author_facet | Gilles Houvenaeghel Marie Bannier Catherine Bouteille Camille Tallet Laura Sabiani Axelle Charavil Arthur Bertrand Aurore Van Troy Max Buttarelli Charlène Teyssandier Agnès Tallet Alexandre de Nonneville Monique Cohen |
| author_sort | Gilles Houvenaeghel |
| collection | DOAJ |
| description | Introduction: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. Methods: We analyzed all complications and grade 2–3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR. Results: Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR (<i>p</i> = 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2–3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2–3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2–3 complications. Conclusions: Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique. |
| first_indexed | 2024-04-24T18:28:24Z |
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| language | English |
| last_indexed | 2024-04-24T18:28:24Z |
| publishDate | 2024-03-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d0a77d8fdc5e4aaab0bf28faf1ff7f6d2024-03-27T13:29:54ZengMDPI AGCancers2072-66942024-03-01166112910.3390/cancers16061129Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast ReconstructionGilles Houvenaeghel0Marie Bannier1Catherine Bouteille2Camille Tallet3Laura Sabiani4Axelle Charavil5Arthur Bertrand6Aurore Van Troy7Max Buttarelli8Charlène Teyssandier9Agnès Tallet10Alexandre de Nonneville11Monique Cohen12Aix-Marseille University, CNRS (National Center of Scientific Research), INSERM (National Institute of Health and Medical Research), Paoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Radiotherapy, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Radiotherapy, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Radiotherapy, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FranceAix-Marseille University, CNRS (National Center of Scientific Research), INSERM (National Institute of Health and Medical Research), Paoli-Calmettes Institute, Department of Medical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FrancePaoli-Calmettes Institute, Department of Surgical Oncology, CRCM (Research Cancer Centre of Marseille), 13009 Marseille, FranceIntroduction: Immediate breast reconstruction (IBR) techniques are rapidly evolving. We compared the results from a single-center implant IBR cohort between subpectoral and prepectoral implants with and without a mesh. Methods: We analyzed all complications and grade 2–3 complications, the implant loss rate, the surgery time, the length of stay (LOS), patient satisfaction, the interval time to adjuvant therapy and cost, with a comparison between subpectoral and prepectoral implant IBR. Results: Subpectoral implant IBR was carried out in 529 mastectomies (62.0%) and prepectoral in 324, with a significant increase in prepectoral placement in recent years. Mesh was used in 176 prepectoral placements (54.3%). Any grade of complication was reported in 147 mastectomies (17.2%), with a significantly higher rate for prepectoral implant IBR (<i>p</i> = 0.036). Regression analysis showed that prepectoral implant was not significantly associated with any grade of complication or with grade 2–3 complications. Prepectoral implant IBR was associated with a significantly shorter operative time and lower LOS. Grade 2–3 complications were significantly associated with lower satisfaction. Higher costs were significantly associated with the subpectoral placement and mesh. A complication rate predictive score identified five groups with a significant increase in grade 2–3 complications. Conclusions: Prepectoral-M-IBR increased over time with no difference in complication rates compared to subpectoral-M-IBR. Prepectoral implant placement can be considered a safe technique.https://www.mdpi.com/2072-6694/16/6/1129breast cancerreconstructionprepectoral implantpost-surgical outcomesatisfactioncost |
| spellingShingle | Gilles Houvenaeghel Marie Bannier Catherine Bouteille Camille Tallet Laura Sabiani Axelle Charavil Arthur Bertrand Aurore Van Troy Max Buttarelli Charlène Teyssandier Agnès Tallet Alexandre de Nonneville Monique Cohen Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction Cancers breast cancer reconstruction prepectoral implant post-surgical outcome satisfaction cost |
| title | Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction |
| title_full | Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction |
| title_fullStr | Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction |
| title_full_unstemmed | Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction |
| title_short | Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction |
| title_sort | postoperative outcomes of pre pectoral versus sub pectoral implant immediate breast reconstruction |
| topic | breast cancer reconstruction prepectoral implant post-surgical outcome satisfaction cost |
| url | https://www.mdpi.com/2072-6694/16/6/1129 |
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