Comparación de los efectos de la radioterapia sobre los resultados estéticos y complicaciones en reconstrucciones mamarias inmediatas versus diferidas con TRAM pediculado / Comparison of the effects of radiotherapy on the aesthetic results and complications in immediate versus delayed breast reconstruction with pedicled TRAM

ABSTRACT

Negative effect of post-mastectomy radiotherapy in transverse rectus abdominus myocutaneous (TRAM) flap breast reconstruction remains unclear. The immediate post-mastectomy TRAM has shown better cosmetic results than delayed reconstruction, making it necessary to define the effects of radiation on this type of reconstruction. The aim of this study is to compare the effect of radiotherapy on immediate and delayed reconstruction with TRAM, analyzing aesthetic results and complications. We reviewed medical records of 23 patients undergoing mastectomy with TRAM reconstruction and radiation therapy between 2004-2009, distributed in those undergoing immediate reconstruction (n=12) and delayed post-radiotherapy (n=11). Cosmetic results and complications were compared between the groups. There were no differences in age, prevalence of comorbidities or clinical stage. Regarding the aesthetic result of immediate TRAM, 50 percent were classified as excellent, 20 percent very well, 20 percent good and 10 percent regular, while in delayed reconstructions, 64 percent was excellent, 18 percent very good and 18 percent good, no differences between both groups (p=0.51). There were no differences in local complications. Although the study population is insufficient to draw conclusions comparable, our results are comparable to those of other studies showing no deleterious effect of radiotherapy on immediate TRAM reconstructions. Additional studies are needed to recommend the treatment of choice.