1.Mesh Selection In Immediate One Stage IBBR Following Mastectomy 2.Comparative Analysis Between Surgisis Mesh-Assisted IBBR,Expander/Implant Breast Reconstruction And Latissimus Dorsi Flap Breast Reconstruction

Background:To investigate the postoperative patient-reported outcomes(PROs)and complications in patients with and without biological mesh-assisted one-stage implant-based breast reconstruction(IBBR).And to further compare and analyze the postoperative PROs and complications between biological mesh-assisted one-stage IBBR and synthetic mesh-assisted one-stage IBBR.Method:This study retrospective analyzed patients who underwent no-mesh assisted one-stage IBBR,Surgisis mesh-assisted one-stage IBBR and TiLOOP mesh-assisted one-stage IBBR following skin-and nipple-sparing mastectomy from May 2015 to January 2020.We firstly compared the postoperative quality of life and complications in patients with and without mesh-assisted one-stage IBBR.Then we investigated the postoperative outcomes of patients between Surgisis mesh-assisted one-stage IBBR and TiLOOP mesh-assisted one-stage IBBR.And we further analyzed the factors influencing the different dimensions of PROs between the Surgisis mesh group and TiLOOP mesh group.In this study,the BREAST-Q version 2.0 questionnaire was used to assess PROs from health-related quality of life dimension,the satisfaction domain and the experience domain.Postoperative complications were divided into major complications(complications requiring surgical treatment to the hospital)and minor complications(complications that could be treated in the dressing change room).Result:According to the inclusion and exclusion criteria,a total of 192 patients were enrolled.Among them,76 patients(39.6%)underwent no-mesh assisted one-stage IBBR,79 patients(41.1%)underwent Surgisis mesh assisted one-stage IBBR,and 37 patients(19.3%)underwent TiLOOP mesh assisted one-stage IBBR.163 of the 192 patients(84.9%)completed the BREAST-Q version 2.0 questionnaire.In terms of PROs,postoperative breast satisfaction was slightly higher in the Surgisis mesh-assisted one-stage IBBR than in the no-mesh-assisted one-stage IBBR(p=0.045).Also in the breast satisfaction domain,the Surgisis mesh-assisted one-stage IBBR was slightly better than the TiLOOP mesh-assisted one-stage IBBR(p=0.051).In terms of postoperative complications,there was no significant difference between the no-mesh-assisted one-stage IBBR and the Surgisis mesh-assisted one-stage IBBR.Similarly,there was no statistically significant difference in postoperative complications between the Surgisis mesh-assisted one-stage IBBR and the TiLOOP mesh-assisted one-stage IBBR.Conclusion:This study found that postoperative breast satisfaction was higher in Surgisis mesh-assisted one-stage IBBR compared to no-mesh-assisted one-stage IBBR,with no significant differences in postoperative complications between the two groups.In a comparative analysis of Surgisis mesh-assisted one-stage IBBR and TiLOOP mesh-assisted one-stage IBBR,it was found that patients in the Surgisis mesh-assisted one-stage IBBR had slightly higher breast satisfaction than patients in the TiLOOP mesh-assisted one-stage IBBR,and the results may provide breast surgeons with a new way of thinking.Background: To investigate patient-reported outcomes(PROs)and complications between Surgisis mesh-assisted one-stage implant-based breast reconstruction(IBBR)and tissue expander/implant breast reconstruction,and we also compared the outcomes between Surgisis mesh-assisted one-stage IBBR and latissimus dorsi flap breast reconstruction.Method: This study was a retrospective analysis of patients who underwent Surgisis mesh-assisted one-stage IBBR.expander/implant breast reconstruction,and latissimus dorsi flap breast reconstruction from August 2010 to June 2019 at our institution.PROs were assessed using the BREAST-Q version 2.0 questionnaires in terms of health-related quality of life domain,the satisfaction domain,and the experience domain.The study assessed the incidence of postoperative complications in each group of patients,and postoperative complications were classified into major and minor complications according to their condition.Result: A total of 180 patients with breast reconstruction were enrolled according to the inclusion and exclusion criteria.Of the 180 patients,139(77.2%)patients completed the BREAST-Q version 2.0.In terms of PROs,patients in the Surgisis mesh-assisted one-stage IBBR had a higher breast satisfaction score of(60.27± 17.71),which was slightly higher than the mean score of(51.00±13.29)in the expander/implant breast reconstruction,p=0.012.Patients in the latissimus dorsi flap breast reconstruction group had a higher mean score in the psychosocial well-being.In the sexual well-being module,the mean score of patients in the latissimus dorsi flap breast reconstruction was slightly higher than that of patients in the Surgisis mesh-assisted IBBR(73.52± 19.96),p=0.008.In terms of postoperative complications,the incidence of minor complications was higher in the Surgisis mesh-assisted one-stage IBBR than in the expander/implant breast reconstruction,with no statistical difference in the incidence of major complications between the two groups.In contrast,there was no statistical difference in the incidence of major and minor complications between the Surgisis mesh-assisted one-stage IBBR and the latissimus dorsi flap breast reconstruction.Conclusion: In this study,the postoperative complication rate was slightly higher in the Surgisis mesh-assisted one-stage IBBR than in the expander/implant breast replacement,but in terms of patient-reported outcomes,breast satisfaction was higher in the Surgisis mesh-assisted one-stage IBBR than in the expander/implant breast reconstruction.Compared to Surgisis mesh-assisted one-stage IBBR,patients with latissimus dorsi flap breast reconstruction scored higher in psychosocial well-being and sexual well-being,while there was no statistical difference in the incidence of postoperative complications between the two groups.