ABSTRACT
The study was aimed at assessing the role of chemokines in inflammatory changes in tissue following abdominoplasty. The levels of neutrophil-coupled chemokines and their receptors in the serum and blood cells, as well as in cells isolated from the subcutaneous adipose tissue sampled during abdominoplasty were compared in patients with obesity and normal body weight. The levels of chemokines CCL3, CCL3, and CCL5 in blood serum and expression of chemokine receptor CXCR2 and CXCR6 on blood neutrophils were significantly higher (p<0.05) in obese patients in comparison with patients with normal body weight. Elevated expression of chemokines CCL2, CCL3, CCL4, CCL5, CCL18, and CCL20 (p<0.05) was detected in subcutaneous adipose tissue cells isolated obese patients in comparisons with persons with normal body weight. These findings attest to favorable conditions for enhanced neutrophil migration to the adipose tissue in patients with obesity, which can promote leukocyte infiltration of the suture site after abdominoplasty and serves as additional risk factor for the development of postoperative complications associated with activity of neutrophil-derived proteolytic enzymes.
Subject(s)
Chemokine CCL2/metabolism , Chemokine CCL3/metabolism , Chemokine CCL5/metabolism , Ideal Body Weight , Neutrophils/metabolism , Obesity/metabolism , Subcutaneous Fat/metabolism , Abdominoplasty , Adolescent , Adult , Aged , Body Mass Index , Case-Control Studies , Chemokine CCL2/blood , Chemokine CCL3/blood , Chemokine CCL5/blood , Female , Humans , Ideal Body Weight/physiology , Male , Middle Aged , Obesity/pathology , Obesity/surgery , Subcutaneous Fat/pathology , Young AdultABSTRACT
The report deals with retrospective research in possible induction of relapse by breast reconstruction carried out simultaneously with surgery for breast cancer. The end results were compared between cases of modification of radical mastectomy combined with reconstruction (n=124) and controls who underwent surgery for cancer alone (n=379). Standard radio- and systemic therapy was used. Median follow-up was 64 months. Local and general recurrence as well as relapse-free and overall survival rates were identical. Multivariate analysis failed to establish any correlation between primary breast reconstruction and relapse. Nor did it increase the risk of the development of the latter.
Subject(s)
Breast Neoplasms/surgery , Mammaplasty/adverse effects , Mammaplasty/methods , Mastectomy, Modified Radical , Adult , Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Chemotherapy, Adjuvant , Disease-Free Survival , Female , Follow-Up Studies , Humans , Middle Aged , Multivariate Analysis , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/prevention & control , Radiotherapy, Adjuvant , Retrospective Studies , Risk Assessment , Risk Factors , Survival Analysis , Time FactorsABSTRACT
Psychological impact of modified radical mastectomy carried out simultaneously with breast reconstruction (n=45) was compared with that in controls who underwent similar surgery for cancer alone (n=50). After 12 months, depression was less frequent in group 1 and indices such as being a good mixer, joyfulness, activity, happiness, job satisfaction and access to leisure and entertainment were significantly higher than among controls (p< or =0.05). However, deep depression persisted in group 1 (13%) as long as for 12 months and intense angst in 17.8%.
Subject(s)
Anxiety/epidemiology , Breast Neoplasms/psychology , Breast Neoplasms/surgery , Depression/epidemiology , Mammaplasty , Quality of Life , Adult , Aged , Anxiety/etiology , Anxiety/prevention & control , Depression/etiology , Depression/prevention & control , Female , Humans , Incidence , Mammaplasty/psychology , Middle Aged , Retrospective Studies , Russia/epidemiology , Time FactorsABSTRACT
Different procedures of breast reconstruction were employed in the treatment of 223 breast cancer patients (primary reconstruction-97; delayed reconstruction-136). No major complications were recorded, including total necrosis of transverse abdominal island flap. The advantage offered by the latter is due to its resistance to chemoradiotherapy: complications such as boundary necrosis do not destroy cosmetic effect as in the case of expander application.
