Early postoperative complications of breast reconstruction by history of radiotherapy and reconstruction approach

Background For patients undergoing postmastectomy breast reconstruction, early postoperative complications may represent remarkable physical and emotional burden. Preoperative risk assessment is essential to minimizing such complications. The aim was to compare postoperative inpatient stay and early postoperative complications by radiotherapy status and different types of breast reconstruction. Methods A total of 95 patients who had undergone postmastectomy primary breast reconstruction in a delayed manner in our institution were reviewed. A retrospective analysis was performed on the clinical data of patients with or without history of radiation therapy who had undergone implant, autologous, or combined reconstruction. The Kruskal-Wallis test, chi-square test of independence, and one-way ANOVA were used for data analysis. Results Patients with a history of radiotherapy as well as patients who had undergone autologous reconstruction had the longest operative times (p= 0.020; p < 0.001), length of stay in the ICU (p =0.010; p < 0.001), and overall length of postoperative inpatient stay (p = 0.049; p < 0.001). The rate of postoperative complications was 40% with previous radiotherapy compared to 12.3% without previous radiotherapy (p = 0.002), and 42.1% with autologous reconstruction compared to 8.3% with implant reconstruction and 6.1% with combined reconstruction (p < 0.001). Conclusions History of radiotherapy and autologous reconstruction were associated with significantly longer operative times, inpatient stays, and a higher risk of early postoperative complications. Despite use of the patient's own tissue in combined reconstruction, there were no significant differences between the implant and combined reconstruction methods.