Background and Aims: breast reconstruction with silicone prosthesis following nipplesparing mastectomy has become widely accepted as a reconstruction option in women requiring mastectomy for cancer. the purpose of this study was to evaluate the incidence and some factors influencing early local complications in patients undergoing nsm with immediate implant reconstruction.Material and Methods: prospective study was performed on a consecutive series of 214 breast reconstructions in 205 patients. all complications during the six weeks after surgery were recorded. 42 prostheses were implanted after neoadjuvant chemotherapy, 27 patients previously had radiotherapy due to breast conserving surgery and in all other cases surgery was the primary treatment for cancer.Results: the overall six-week complication rate was 16% (35) and included: major skin flap necrosis (4%, 9 procedures), minor skin necrosis (3%, 7), major infection (2%, 5), minor infection (3%, 7), prolonged seroma formation (3%, 6), haematoma (1%, 2) and epidermolysis (1%, 2). in 6% (12) reconstruction procedures explantation of prosthesis was done. neoadjuvant chemotherapy and radiotherapy were not associated with higher rate of complications.Conclusion: nipple-sparing mastectomy with immediate implant reconstruction has acceptable morbidity rate in the hand of experienced oncoplastic surgeon and therefore should be considered as treatment option to women requiring mastectomy.
ERUS provides a good accuracy rate for staging rectal cancer after neoadjuvant chemoradiation. However, it is insufficient in detection of complete pathological response.
Routine use of stapling surgery, subspecialization in surgery, and better early intensive care monitoring and treatment could reduce the mortality rate.
The CSA and DSA techniques are equally safe for the creation of a rectal anastomosis, without any significant difference in the AL rate. However, we recommend using the DSA technique because it has other definite advantages. In cases of neoadjuvant treatment and a low anastomosis, proximal diversion is recommended.
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