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Preoperative Neutrophil / Lymphocyte ratio as a predictor of mastectomy flap necrosis.
Moheb Said. M.D. Basem Azab MD (University of Miami). Vitali Azouz MD. Douglas Wagner
Summa Health Care System. Akron. Ohio
2018-02-14
Presenter: Moheb Said
Affidavit:
70% of the work is the fellow's original work
Director Name: Douglas Wagner
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Preoperative Neutrophil / Lymphocyte ratio as a predictor of mastectomy flap necrosis.
Moheb Said. M.D., Basem Azab MD (University of Miami), Vitali Azouz MD. Douglas Wagner
Skin Sparing Mastectomy provides superior aesthetic outcome in immediate breast reconstruction without compromising oncological safety 1-3
One of the complications of Skin Sparing Mastectomy is Mastectomy Flap Necrosis, with a reported incidence of 12-30% 4-9. This complication, adversely affects the aesthetic outcome, increases the incidence of reoperation and delays oncologic management.
Mastectomy flap necrosis shares the same risk factors that determine increasing morbidity and mortality in coronary revascularization interventions (percutaneous coronary intervention and coronary artery bypass grafting). These risk factors include, advanced age (>65years), obesity (BMI>30), and active smoking. 10-11
The Neutrophil to lymphocyte ratio (N/L ratio) as an inflammatory marker has been shown to independently predict mortality in patients undergoing CABG, PCI and major vascular surgery. 12-15
We will study N/L ratio in immediate breast reconstruction following skin or nipple sparing mastectomy.
We hypothesize that an observational study will evaluate preoperative predictability of N/L ratio for mastectomy flap necrosis.
References:
1-BonetiC,YuenJ,SantiagoC,etal.Oncologicsafetyofnipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. J Am Coll Surg. 2011;212:686–693; discussion 693–695.
2- Cense HA, Rutgers EJ, Lopes Cardozo M, Van Lanschot JJ. Nipple-sparing mastectomy in breast cancer: A viable option? Eur J Surg Oncol. 2001;27:521–526.
3- de Alcantara Filho P, Capko D, Barry JM, Morrow M, Pusic A, Sacchini VS. Nipple-sparing mastectomy for breast cancer and risk-reducing surgery: The Memorial Sloan-Kettering Cancer Center experience. Ann Surg Oncol. 2011;18:3117– 3122.
