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. 2023 Oct 1;152(4):578e-589e.
doi: 10.1097/PRS.0000000000010348. Epub 2023 Mar 3.

Same-Day Mastectomy and Immediate Prosthetic Breast Reconstruction: A 12-Year National Database Analysis and Early Postoperative Outcomes

Affiliations

Same-Day Mastectomy and Immediate Prosthetic Breast Reconstruction: A 12-Year National Database Analysis and Early Postoperative Outcomes

Amanda L Chow et al. Plast Reconstr Surg. .

Abstract

Background: Coronavirus disease of 2019 and rising health care costs have incentivized shorter hospital stays after mastectomies with immediate prosthetic reconstruction. The purpose of this study was to compare postoperative outcomes following same-day and non-same-day mastectomy with immediate prosthetic reconstruction.

Methods: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2007 to 2019 was performed. Patients who underwent mastectomies and immediate reconstruction with tissue expanders or implants were selected and grouped based on length of stay. Univariate analysis and multivariate regression were performed to compare 30-day postoperative outcomes between length-of-stay groups.

Results: A total of 45,451 patients were included: 1508 had same-day surgery (SDS) and 43,942 were admitted for 1 or more night (non-SDS). There was no significant difference in overall 30-day postoperative complications between SDS and non-SDS following immediate prosthetic reconstruction. SDS was not a predictor of complications (OR, 1.1; P = 0.346), whereas tissue expander reconstruction decreased odds of morbidity compared with direct-to-implant reconstruction (OR, 0.77; P < 0.001). Among patients who had SDS, smoking was significantly associated with early complications on multivariate analysis (OR, 1.85; P = 0.010).

Conclusions: This study provides an up-to-date assessment of the safety of mastectomies with immediate prosthetic breast reconstruction that captures recent advancements. Postoperative complication rates are similar between same-day discharge and at least 1-night stay, suggesting that same-day procedures may be safe for appropriately selected patients.

Clinical question/level of evidence: Therapeutic, III.

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References

    1. Qin C, Antony AK, Aggarwal A, Jordan S, Gutowski KA, Kim JYS. Assessing outcomes and safety of inpatient versus outpatient tissue expander immediate breast reconstruction. Ann Surg Oncol. 2015;22:3724–3729.
    1. Steiner CA, Weiss AJ, Barrett ML, Fingar KR, Davis PH. Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013: Statistical Brief #201. Washington, DC: Agency for Healthcare Research and Quality (US); 2006.
    1. Cortina CS, Patten CR, Adamson K, Doren EL. Enhanced recovery after surgery (ERAS): protocols in post-mastectomy breast reconstruction. Curr Breast Cancer Rep. 2020;12:398–404.
    1. Specht M, Sobti N, Rosado N, et al. High-efficiency same-day approach to breast reconstruction during the COVID-19 crisis. Breast Cancer Res Treat. 2020;182:679–688.
    1. Cordeiro E, Zhong T, Jackson T, Cil T. The safety of same-day breast reconstructive surgery: an analysis of short-term outcomes. Am J Surg. 2017;214:495–500.