Autologous vs prosthetic breast reconstruction : Where do we stand ?
Ce dossier présente deux études sur la reconstruction mammaire après mastectomie, l'une comparant les taux de complications à 2 ans associés aux techniques courantes de reconstruction (2 343 patientes ; âge moyen : 49,5 ans), l'autre évaluant la satisfaction et la qualité de vie auto-rapportées (bien être psychologique, physique et sexuel) de 1 217 patientes en fonction du type de reconstruction (par implants ou tissus autologues)
In this issue of JAMA Surgery, 2 studies based on a prospective cohort, the Multicenter Reconstruction Outcomes Consortium, examine the outcomes of breast reconstruction across 11 centers.1,2 The first study examined complication rates of postmastectomy breast reconstruction at 2 years after surgery.1 Patients who underwent autologous reconstruction had greater odds of developing complications and experiencing reoperative complications compared with patients who underwent prosthetic reconstruction, but had a lower chance of infection and failure. Overall failure rates were 7.1% with implant-based techniques and 1.2% for deep inferior epigastric artery perforator flaps. A startling finding was the rate of reoperative complications, which ranged from 15.5% for expander implant reconstruction to 29.2% for the deep inferior epigastric artery perforator flap procedure. These rates are similar to those published by Alderman et al3 in the 2-year follow-up of the Michigan Breast Reconstruction Outcome study conducted more than 15 years ago. Further analysis of the reoperative complications will help us understand and improve these numbers.
JAMA Surgery , commentaire en libre accès, 2017