LI Danxi , HOU Lan , WANG Zhe , HE Xiangmei , WANG Donghui , YANG Liu , QIN Yuan , ZHANG Huan , ZHANG Mingkun , ZHAO Ge , ZHANG Juliang
  • Department of Thyroid and Mammary Vascular Surgery, The First Affiliated Hospital of Air Force Military Medical University, Xi’an 710032, P. R. China;
ZHANG Juliang, Email: vascularzhang@163.com
day surgery; lumpectomy; breast implant reconstruction; safety
10.7507/1007-9424.202411072
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Objective To investigate the safety of day surgery service model for one-stage prosthetic reconstruction after radical lumpectomy for breast cancer. Methods The breast cancer patients who underwent luminal prosthesis reconstruction at The First Affiliated Hospital of Air Force Military Medical University from January 2021 to December 2023 were retrospectively collected. The patients were assigned into an ambulatory group (ambulatory surgical service model) and an inpatient unit group (inpatient unit surgical service model) according to their surgical service modalities. The baseline data, surgical safety, tumor safety-related indexes, and postoperative quality of life indicators by Breast-Q 2.0 score of the two groups were compared. Results There were 239 patients who met the selection criteria were included, including 146 in the ambulatory group and 93 in the inpatient unit group. Except for the age and menopausal status of the patients of two groups (P<0.05), there were no statistically significant differences in body mass index, chronic medical history, previous surgical history, molecular typing, tumor length, neoadjuvant chemotherapy, and radiotherapy between the the patients of two groups (P>0.05). In the surgery-related safety indexes, except for the total hospitalization time and postoperative drainage in the ambulatory group, which were significantly lower than those in the inpatient unit group (P<0.05), the differences between the two groups in terms of operation time, intraoperative bleeding, prosthesis size, postoperative dietary recovery time, postoperative pain score, and axillary lymph node dissection rate were not statistically significant (P>0.05). No significant difference was seen in the incidence of nipple-areola complex ischemia, flap ischemia, infection, implant loss, and the incidence of pericardial contracture among the early postoperative complications. The average follow-up time in the ambulatory group and inpatient unit group was (13.31±7.29) months and (13.41±9.02) months, respectively. All patients survived, among them, one patient (0.68%) in the ambulatory group and two patients (2.15%) in the inpatient unit group experienced local recurrence, and there was no significant difference in the rate of local recurrence between the two groups (P>0.05). In the Breast-Q 2.0 score, the information satisfaction of the patients in the inpatient unit group was significantly higher than that of in the inpatient unit group, and there were no statistical significances in the breast satisfaction, social satisfaction, and physician satisfaction. Conclusions From the results of this study, day surgery for one-stage prosthetic reconstruction after radical lumpectomy for breast cancer is safe can also improve the patient’s experience of care.

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