Closing the Loop on Revision: The Impact of Emotional Well-being on Elective Revision After Breast Reconstruction.

IF 3 2区 医学 Q1 SURGERY Aesthetic Surgery Journal Pub Date : 2024-11-15 DOI:10.1093/asj/sjae155
Casey Zhang, Vivian L Wang, Shayan Sarrami, Pooja D Reddy, Carolyn De La Cruz
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Abstract

Background: A diagnosis of breast cancer has a significant impact on a patient's physical and emotional health. Breast reconstruction improves quality of life and self-esteem following mastectomy. However, many patients undergo additional elective revision procedures after reconstruction.

Objectives: The aim of this study was to assess the relationship between perioperative emotional well-being and elective revisions in breast reconstruction.

Methods: A retrospective review was performed of patients who underwent breast reconstruction with a single surgeon between January 2007 and December 2017. Revision procedures were defined as additional operations that fall outside the index reconstructive plan. Medical records were reviewed for a history of generalized anxiety disorder (GAD) and/or major depressive disorder. Multivariate analysis was performed to identify factors associated with revision.

Results: A total of 775 patients undergoing breast reconstruction were included, of whom 121 (15.6%) underwent elective revision. Overall, a history of any psychiatric history (P < .001), depression alone (P = .001%), and GAD and depression together (P = .003) were significantly associated with revision surgery. On multivariate logistic regression controlling for comorbidities and reconstruction modality, depression alone, and GAD and depression together were significantly associated with an increased likelihood of revision surgery (odds ratio, 3.20, P < .001; odds ratio, 2.63, P < .001).

Conclusions: Perioperative emotional well-being and reconstruction modality impact the rate of secondary revision surgery. An understanding of the surgical and patient-related risk factors for revision can provide more informed patient-decision making and improve surgical planning.

Level of evidence: 3:

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乳房再造的闭环:情感健康对乳房再造术后选择性翻修的影响。
背景:乳腺癌的诊断对患者的身体和情绪健康有重大影响。乳房重建可提高乳房切除术后的生活质量和自尊。然而,许多患者在乳房再造术后还要接受额外的选择性翻修手术:本研究旨在评估围手术期情绪健康与乳房再造选择性翻修之间的关系:方法:对2007年1月至2017年12月期间在一位外科医生处接受乳房重建手术的患者进行回顾性研究。翻修手术被定义为在指标重建计划之外的额外手术。对病历中的广泛性焦虑症(GAD)和/或重度抑郁症(MDD)病史进行了回顾。进行多变量分析以确定与翻修相关的因素:共纳入了 775 名接受乳房重建的患者,其中 121 人(15.6%)接受了选择性翻修。总体而言,有任何精神病史(p结论:围手术期的情绪健康和重建方式会影响二次翻修手术的发生率。了解手术和患者相关的翻修风险因素可以为患者决策提供更多信息,并改善手术规划。
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来源期刊
CiteScore
6.20
自引率
20.70%
发文量
309
审稿时长
6-12 weeks
期刊介绍: Aesthetic Surgery Journal is a peer-reviewed international journal focusing on scientific developments and clinical techniques in aesthetic surgery. The official publication of The Aesthetic Society, ASJ is also the official English-language journal of many major international societies of plastic, aesthetic and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of the British Association of Aesthetic Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery and The Rhinoplasty Society.
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