PURPOSE The impact of neoadjuvant chemotherapy on the surgical outcomes of immediate breast reconstruction remains controversial. The aim of this study was to analyze the incidence of complications of immediate deep inferior epigastric artery perforator (DIEP) flap breast reconstructions in patients who received neoadjuvant chemotherapy compared to patients without neoadjuvant chemotherapy prior to surgery. METHODS A multicenter, retrospective cohort study was conducted of all patients who underwent immediate DIEP flap breast reconstruction between January 2010 and June 2017. Patients were divided in two groups as breast reconstructions with or without neoadjuvant chemotherapy, respectively. The primary outcome was the incidence of postoperative flap re-explorations, recipient-site complications and donor-site complications. RESULTS In total 432 immediate DIEP flap breast reconstructions in 326 patients were included. Forty-eight patients (n = 67 flaps) received neoadjuvant chemotherapy prior to immediate breast reconstruction and 278 patients (n = 365 flaps) did not. No statistically significant differences for any major (4.5% vs. 10.4%; p = 0.175) or minor (16.4% vs. 24.7%; p = 0.191) recipient-site complication were observed. Donor-site complications were recorded in 9 (18.8%) and 62 (22.2%) patients, respectively (p = 0.587). There was no difference in need for flap re-exploration between groups (3.0% vs. 8.5%; p = 0.139). Correction for potential confounding variables did not result in significant differences. CONCLUSIONS This study demonstrated similar complication rates for patients with and without neoadjuvant chemotherapy prior to immediate breast reconstruction, indicating that it is safe to perform an immediate DIEP flap breast reconstruction after neoadjuvant chemotherapy.

中文翻译：

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新辅助化疗对立即DIEP皮瓣乳房重建术并发症的影响。

目的新辅助化疗对立即乳房重建手术结果的影响尚存争议。这项研究的目的是分析接受新辅助化疗的患者与未经术前新辅助化疗的患者相比，立即深部下腹上动脉穿支穿孔（DIEP）皮瓣乳房再造的并发症发生率。方法对2010年1月至2017年6月立即进行DIEP皮瓣乳房再造术的所有患者进行多中心回顾性队列研究。将患者分为两组，分别接受或不接受新辅助化疗。主要结局是术后皮瓣重新探查，受体部位并发症和供体部位并发症的发生率。结果总共纳入326例患者中的432例立即进行DIEP皮瓣乳房再造。48例患者（n = 67个皮瓣）在立即进行乳房重建之前接受了新辅助化疗，而278例患者（n = 365个皮瓣）未接受新辅助化疗。没有观察到任何重大（4.5％vs. 10.4％； p = 0.175）或较小（16.4％vs. 24.7％； p = 0.191）接受者部位并发症的统计学差异。分别有9名患者（18.8％）和62名患者（22.2％）记录了供体部位并发症（p = 0.587）。两组之间皮瓣再探的需要没有差异（3.0％vs. 8.5％； p = 0.139）。校正潜在的混淆变量不会导致显着差异。