Influence of radiation therapy on the development of complications in single-stage autologous breast reconstruction with a DIEP-flap in breast cancer patients: a retrospective study
- Authors: Duadze I.S.1,2, Kaprin A.D.3,4, Zikiryakhodzhaev A.D.1,2,4, Reshetov I.V.1, Usov F.N.2, Rasskazova E.A.2, Sukhotko A.S.5, Starkova M.V.2, Bagdasarova D.V.2, Dzhabrailova D.S.2, Khakimova S.G.6
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Affiliations:
- Sechenov First Moscow State Medical University (Sechenov University)
- Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
- National Medical Research Radiological Centre
- People’s Friendship University of Russia (RUDN University)
- Botkin Hospital
- Tashkent Pediatric Medical Institute
- Issue: Vol 25, No 1 (2023)
- Pages: 68-72
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/132796
- DOI: https://doi.org/10.26442/18151434.2023.1.202080
- ID: 132796
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Abstract
Breast reconstruction after complex oncological treatment is an urgent issue due to the high incidence of breast cancer.
Aim. To analyze the effect of postoperative radiotherapy on the incidence of fat necrosis in single-stage autologous breast reconstruction with a DIEP flap and to evaluate the number of complications in groups with and without postoperative radiotherapy, as well as to determine the risk factors for complications.
Materials and methods. The medical records of 34 breast cancer patients who underwent one-stage breast reconstruction using a DIEP flap after skin-sparing/subcutaneous mastectomy with and without subsequent radiation therapy were retrospectively studied. The frequency of complications in groups with and without postoperative radiation therapy was assessed.
Results. Complications developed in 22 (64.7%) patients out of 34. Mild complications developed in 6 (17.6%) patients (divergence of the edges of the postoperative wound of the anterior abdominal wall). Complications of moderate severity developed in 12 (35.3%) patients. Severe complications developed in 4 (11.8%) patients. Out of 22 patients, 6 (17.4%) patients developed areas of fat necrosis after remote radiation therapy in the delayed period, 4 (11.8%) patients, without ESWL, also developed fat necrosis of a part of the flap (areas up to 5 cm). Excision of the area of fat necrosis of the flap was performed in 2 (5.9%) cases under local anesthesia, the rest of the areas of fat necrosis were not excised. The percentage of complications was higher in the group of patients with obesity (20.6%), which indicates that obesity is a risk factor for the development of intraoperative and postoperative complications in patients with simultaneous breast reconstruction with a DIEP flap.
Conclusion. During radiotherapy after breast reconstruction with a DIEP flap, the incidence of fat necrosis of the flap was higher. Obesity is a risk of intraoperative and postoperative complications in patients with simultaneous increased breast reconstruction with a DIEP flap, since the incidence of complications was in the group of patients with obesity.
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##article.viewOnOriginalSite##About the authors
Ilona S. Duadze
Sechenov First Moscow State Medical University (Sechenov University); Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Author for correspondence.
Email: ilona.duadze@mail.ru
ORCID iD: 0000-0002-9577-584X
SPIN-code: 4663-9473
Graduate Student, Sechenov First Moscow State Medical University (Sechenov University), Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation, Moscow; MoscowAndrei D. Kaprin
National Medical Research Radiological Centre; People’s Friendship University of Russia (RUDN University)
Email: ilona.duadze@mail.ru
ORCID iD: 0000-0001-8784-8415
D. Sci. (Med.), Prof., Acad. RAS, National Medical Research Radiological Centre, People’s Friendship University of Russia (RUDN University)
Russian Federation, Moscow; MoscowAziz D. Zikiryakhodzhaev
Sechenov First Moscow State Medical University (Sechenov University); Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre; People’s Friendship University of Russia (RUDN University)
Email: azizz@mail.ru
ORCID iD: 0000-0001-7141-2502
D. Sci. (Med.), Sechenov First Moscow State Medical University (Sechenov University), Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, People’s Friendship University of Russia (RUDN University)
Russian Federation, Moscow; Moscow; MoscowIgor V. Reshetov
Sechenov First Moscow State Medical University (Sechenov University)
Email: ilona.duadze@mail.ru
ORCID iD: 0000-0002-0909-6278
D. Sci. (Med.), Prof., Acad. RAS, Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation, MoscowFedor N. Usov
Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Email: fedus70@mail.ru
ORCID iD: 0000-0001-9510-1434
Cand. Sci. (Med.), Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation, MoscowElena A. Rasskazova
Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Email: rasskaz2@yandex.ru
ORCID iD: 0000-0003-0307-8252
Cand. Sci. (Med.), Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation, MoscowAnna S. Sukhotko
Botkin Hospital
Email: syxotya26@yandex.ru
ORCID iD: 0000-0002-2337-5919
Cand. Sci. (Med.), Botkin Hospital
Russian Federation, MoscowMarianna V. Starkova
Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Email: mariannastarkova@gmail.com
ORCID iD: 0000-0003-4141-8414
Cand. Sci. (Med.), Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation, MoscowDaria V. Bagdasarova
Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Email: dasha.bagdasarova@gmail.com
ORCID iD: 0000-0001-9195-4181
Graduate Student, Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
MoscowDzhamilya S. Dzhabrailova
Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Email: jamijabrailova17@gmail.ru
ORCID iD: 0000-0002-7283-2530
Oncologist, Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation, MoscowShakhnoza G. Khakimova
Tashkent Pediatric Medical Institute
Email: shahnoz_hakimova@mail.ru
ORCID iD: 0000-0001-6660-4649
Cand. Sci. (Med.), Tashkent Pediatric Medical Institute
Uzbekistan, TashkentReferences
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