Trends in outcomes with adoption of indocyanine green angiography in postmastectomy reconstruction
| العنوان: | Trends in outcomes with adoption of indocyanine green angiography in postmastectomy reconstruction |
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| المؤلفون: | Chu Luan Nguyen, Alexander Peter Comerford, Nirmal Dayaratna, Tahmina Lata, Steven Ronald Paredes, Neshanth Easwaralingam, Jue Li Seah, Farhad Azimi, Cindy Mak, Carlo Pulitano, Sanjay Kumar Warrier |
| المصدر: | ANZ Journal of Surgery. 93:270-275 |
| بيانات النشر: | Wiley, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Surgery, General Medicine |
| الوصف: | Indocyanine green angiography (ICGA) aims to reduce ischaemic complications by supplementing intraoperative perfusion assessment of mastectomy flaps. Learning curves for this technology have not been analysed. We evaluated changes in patient outcomes with increasing case volume after ICGA adoption in postmastectomy reconstruction.Single-institution retrospective analysis of 320 implant-based reconstructions following mastectomy using ICGA from 2015, when it was introduced, to 2021. Cases chronologically divided into tertiles and complications amongst groups evaluated. Trends in ischaemic complications plotted using weighted moving average. CUSUM analysis determined after how many cases plateau was reached. Number of ischaemic complications prior to plateau calculated with AUC analysis.Ischaemic complications decreased over time (Group 1, 15.1%; Group 2, 11.2%; Group 3, 4.7%, P = 0.034). Cases of delayed reconstruction increased over time (Group 1, 6.6%; Group 2, 28%; Group 3, 22.4%; P 0.001). Our institution reached plateau of 10% ischaemic complications after 160 cases. Mean incidence of ischaemic complications decreased from 16.9% during the first 160 cases to 3.8% after plateau was reached (P 0.001). Eleven extra breasts (6.9%) experienced ischaemic complications, that may have been avoided if operated by surgeons after the first 160 cases.There was increased tendency towards a conservative approach of delaying reconstruction and decreased rates of ischaemic complications with increasing case volume after ICGA implementation. A significant number of cases were needed to reach plateau of minimal ischaemic complications. This data could encourage development of standardized protocols for this technology to shorten learning curves for improved patient outcomes. |
| تدمد: | 1445-2197 1445-1433 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c96c477f0f17906d8ab30e59801b74d0 https://doi.org/10.1111/ans.18241 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....c96c477f0f17906d8ab30e59801b74d0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14452197 14451433 |
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