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Back to 2017 Program


Evaluating the Safety of Abdominally Based Breast Reconstruction Following Abdominal Surgery
Rachel B. Lentz, MD, Merisa Piper, MD, William Hoffman, MD, Hani Sbitany, MD.
UCSF, San Francisco, CA, USA.

PURPOSE: The popularity of abdominally based free flap breast reconstruction has grown tremendously over the past decade. However, controversy persists regarding the safety of performing these operations in individuals with a prior history of abdominal surgery.
METHODS: We performed a retrospective review of all patients who underwent abdominally based free flap breast reconstruction between 2008-2016. Patient demographics, operative details, and postoperative outcomes were assessed. All patients had at least 3 months of follow up for study inclusion.
RESULTS: We identified 132 patients who underwent 186 abdominally based free flaps. 70 patients (104 breast reconstructions) had a prior history of abdominal surgery. 57 patients (73 breast reconstructions) had no prior abdominal surgeries. Five patients underwent simultaneous gynecologic surgery at the time of their free flap harvest; these patients were excluded from analysis. The groups were appropriately matched with respect to BMI, race/ethnicity, smoking status, and comorbidities. We found no difference in overall abdominal complications requiring surgical intervention (14.5% vs 15.8%, p= 0.84). Incidence of abdominal bulge was greater in the study group (11.4% vs 3.5%, p = 0.099), however this was not statistically significant. Breast related complications were also similar between the two groups. There were no total flap losses in either group. Rates of fat necrosis requiring excision were 15.4% vs 15.1%, p = 0.954.
CONCLUSION: Prior history of abdominal surgery does not significantly increase complications in abdominally based free flap breast reconstruction, and should not preclude patients from undergoing these reconstructions.


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