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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2019

01-06-2019 | Mastectomy | Breast Oncology

Effects of Antihypertensive Drugs on Outcomes of Breast Reconstruction

Authors: Jin-Woo Park, MD, Kyeong-Tae Lee, MD, Byung-Joon Jeon, MD, PhD, Jai-Kyong Pyon, MD, PhD, Sa Ik Bang, MD, PhD, Goo-Hyun Mun, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2019

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Abstract

Background

Angiotensin receptor blocker (ARB), a commonly used antihypertensive drug, is reported to affect wound healing and flap survival in animal models. However, this has not been elucidated in a clinical series. This study aimed to investigate the impact that perioperative use of ARB has on outcomes after breast reconstruction.

Methods

Patients who underwent immediate breast reconstruction using a tissue expander or a deep inferior epigastric perforator (DIEP) flap were reviewed. The patients were categorized according to the types of antihypertensive medications as follows: the ARB group consisted of hypertensive patients treated with ARB alone or a combination of ARB and other drugs; the non-ARB group included those receiving drugs other than ARB; and the control group did not receive any medication. The effects of antihypertensive drugs on the development of complications were evaluated.

Results

The study analyzed 1390 cases including 999 cases of tissue-expander insertion and 391 cases of DIEP flap reconstruction. With regard to tissue-expander reconstruction, the rates of seroma, reoperation, reconstruction failure, and overall complications were significantly higher in the ARB group than in the other two groups. Compared with no medication, ARB use was an independent risk factor for these complications. With regard to DIEP flap reconstruction, the ARB group showed a significantly higher rate of fat necrosis and significantly greater odds for the development of overall perfusion-related complications and fat necrosis than the control group after adjustment for other variables.

Conclusions

Perioperative administration of ARB might be associated with adverse outcomes after breast reconstruction.
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Metadata
Title
Effects of Antihypertensive Drugs on Outcomes of Breast Reconstruction
Authors
Jin-Woo Park, MD
Kyeong-Tae Lee, MD
Byung-Joon Jeon, MD, PhD
Jai-Kyong Pyon, MD, PhD
Sa Ik Bang, MD, PhD
Goo-Hyun Mun, MD, PhD
Publication date
01-06-2019
Publisher
Springer International Publishing
Keywords
Mastectomy
Seroma
Published in
Annals of Surgical Oncology / Issue 6/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07293-z

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