Implant-Based Breast Reconstruction vs TRAM Flap Breast Reconstruction: Solving Problems in a More Simple Way

Abstract

 Background: The surgical management of breast cancer is clearly evolving towards less invasive procedures. We are turning away from high priced medicine and are turning toward solving problems in more practical, simple and inexpensive ways.

The purpose of this study was to evaluate immediate breast reconstruction with expanders and implants versus pedicled TRAM Flaps in terms of costs, complication rates, revision rates, operating room time, length of hospital stay and number of secondary procedures.

Methods: A review of 152 immediate breast reconstructions over a 10 year period from april 2000 and December 2010 performed at our Institution, reconstructive techniques included TRAM Flaps in 70 patients and tissue expanders followed by implants in 82 patients.

Results: In the TRAM Flap group the mean operative time was 5.1 hours, the mean length of hospital stay was 4.2 days and revision surgeries were performed in 6 patients (8.5%). In the implant based group the mean operative time was 2.6 hours (including the mastectomy), the mean length of hospital stay was 1.9 days and revision surgeries were performed in 6 patients (7.3%).

On the basis of this review of autologous and prosthetic breast reconstruction in a 10 year period with a mean follow up time of 5.1 years for both groups, prosthetic reconstruction was significantly less expensive.