Volume 122, Issue 6 pp. 1240-1246
RESEARCH ARTICLE

The effect of sarcopenia on perioperative complications in abdominally based free-flap breast reconstruction

Justin M. Broyles MD

Corresponding Author

Justin M. Broyles MD

Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Massachusetts

Correspondence Justin M. Broyles, MD, Member of the Faculty, Harvard Medical School, Associate Surgeon, Brigham and Women's Hospital, Boston, MA 02115.

Email: [email protected]

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Jeffrey M. Smith MD

Jeffrey M. Smith MD

Division of Plastic and Reconstructive Surgery, The University of Texas Medical Branch, Galveston, Texas

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Brett T. Phillips MD

Brett T. Phillips MD

Division of Plastic and Reconstructive Surgery, Duke University Hospital, Durham, North Carolina

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Alex F. Mericli MD

Alex F. Mericli MD

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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Jesse C. Selber MD, MPH, FACS

Jesse C. Selber MD, MPH, FACS

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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Rene D. Largo MD

Rene D. Largo MD

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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Donald P. Baumann MD, FACS

Donald P. Baumann MD, FACS

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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Jessie Liu PhD

Jessie Liu PhD

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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Mark V. Schaverien MD, MSc, MEd, FRCS

Mark V. Schaverien MD, MSc, MEd, FRCS

Department of Plastic and Reconstructive Surgery, MD Anderson Cancer Center, The University of Texas, Houston, Texas

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First published: 16 July 2020
Citations: 5

Abstract

Purpose

The identification of patient-specific risk factors, which predict morbidity following abdominally based microvascular breast reconstruction is difficult. Sarcopenia is a proxy for patient frailty and is an independent predictor of complications in a myriad of surgical disciplines. We predict that sarcopenic patients will be at higher risk for surgical complications following abdominally based microvascular breast reconstruction.

Methods

A retrospective study of all patients who underwent delayed abdominally based autologous breast reconstruction following postmastectomy radiation therapy from 2007 to 2013 at a single institution was conducted. Univariate and multiple logistic regression models were used to assess the effect of sarcopenia on postoperative outcomes.

Results

Two hundred and eight patients met the inclusion criteria, of which 30 met criteria for sarcopenia (14.1%). There were no significant differences in demographics between groups. There were no significant differences in minor (36.7% vs 44.4%; P = .43) or major (16.7% vs 25.3%; P = .36) complications between groups as well as hospital length of stay. Multivariable logistic regression demonstrated that a staged reconstruction with the use of a tissue expander was the only consistent variable, which predicted major complications (OR, 2.24; 95% CI, 1.18-4.64; P = .015).

Conclusions

Sarcopenia does not predispose to minor or major surgical complications in patients who undergo abdominally based microsurgical breast reconstruction.

CONFLICT OF INTERESTS

The authors declare that there are no conflict of interests.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author, and are not publicly available due to privacy or ethical restrictions.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.