He conducted a pilot study that showed that not only did mastectomies with breast reconstruction take longer to do, but they also gave rise to a greater number of early complications after surgery, such as wound infection, and involved more out-patient appointments and more additional surgery.
This is often overlooked when the performance of a hospital unit is being assessed and this issue needs to be addressed, he said. The point of carrying out this study was to try to measure the additional time needed to perform breast reconstruction after mastectomy because this has important resource implications. Extra theatre staff are needed, operating sessions are longer, and there needs to be more time allocated to see patients at the clinic after surgery.
Mr Dace, who is now a consultant surgeon in Altnagelvin Hospital, Northern Ireland, looked at three groups of ten women who had had mastectomy alone, mastectomy plus expander reconstruction1 or mastectomy plus TRAM2 reconstruction. He compared the length of time of surgery, the duration of their stay in hospital, complications, follow-up and the need for further surgery.
He found that the length of in-patient stay for mastectomy, mastectomy plus expander and mastectomy plus TRAM was 7.1 days, 5.6 and 9.8 days respectively. It took 14 hours to perform ten mastectomies, 23.3 hours to perform 10 mastectomies with expanders, and 41.4 hours to carry out ten mastectomies with TRAM reconstruction. There were two early complications in each of the mastectomy a
Contact: Emma Mason
Federation of European Cancer Societies