Complicações em reconstrução mamária total em pacientes mastectomizadas por câncer de mama: análise comparativa de longo prazo quanto a influência de técnica, tempo de cirurgia, momento da reconstrução e tratamento adjuvante

Abstract

Introduction: Some techniques for total reconstruction of the breast, regardless of complexity, present specific complications, with varying degrees of morbidity. Therefore, the aim of this study was to identify the most frequent complications of the main techniques used for breast reconstruction, and to compare these complications to the relevant independent variables. Methods: This cross-sectional observational study was conducted by reviewing the medical records of patients who had their breasts completely rebuilt after a mastectomy due to breast cancer from January 2007 to December 2009, with a minimum postoperative follow-up of 3 years. The data collected, such as the timing of the intervention, reconstruction techniques, operative time, and adjuvant treatment, were statistically related to the presence of complications. Results: Of the 48 total breast reconstructions analyzed, the technique in which expanders were used followed by replacement with implants showed the lowest prevalence of complications (16.7%, P < 0.000). Some techniques showed specific complications. The operative time for transplantation of transverse rectus abdominis musculocutaneous flap (363.57 ± 59.91 min) was significantly higher than that required for techniques using alloplastic materials (155.71 ± 38.02 min, P = 0.01), but similar to that for the latissimus dorsi flap (309.69 ± 77.66 min). The operative time, timing of surgical intervention, and type of adjuvant treatment did not correlate with the incidence of complications. Conclusions: Each technique has its indications, contraindications, and complications. The application of each technique should be individualized on the basis of the individual characteristics of the patient to obtain better results, avoiding short-and long-term complications.

Intervenções fisioterapêuticas utilizadas na reabilitação funcional do membro superior de mulheres pós-mastectomia

“…Com a melhor compreensão das características biológicas dos tumores mamários, o tratamento cirúrgico passou a ser menos agressivo [8]. Porém, independente dos avanços tecnológicos e da abordagem cirúrgica utilizada esses procedimentos ainda estão associados a uma alta prevalência de complicações no membro superior homolateral à cirurgia.…”