Objective To study the postoperative complications and its risk factors in patients undergoing breast reconstruction with abdominal flaps.Methods The clinical data of patients undergoing breast reconstruction with abdominal flaps at Department of Breast Oncoplastic Surgery,Tianjin Medical University Cancer Institute and Hospital from Jan 2011 to Apr 2022 were reviewed.Results Postoperative complications occurred in 95 of 484 patients(19.6％),15.5％had flap complications,5.2％had donor-site complications,and fat necrosis was the most common complication(11.9％).The rate of fat liquefaction decreased significantly through technical improvement(1.7％vs.7.0％);By univariate analysis,there were statistically significant differences among the groups by reconstructive type,neoadjuvant chemotherapy,BMI,smoking history(x2=21.088,P＜0.001;x2=4.385,P=0.036;x2=14.784,P=0.018;x2=19.015,P=0.048).Unplanned reoperation statistically related to the timing of reconstruction,and reconstructive type(x2=7.316,P=0.007;x2=17.167,P＜0.001).Revision surgery significantly related to the timing of reconstruction and timing of radiation(x2=40.785,P＜0.001;x2=18.602,P＜0.001);By multivariate analysis,deep inferior epigastric perforator flap,smoking history were independent risk factors for flap necrosis(OR=0.084,95％CI:0.022-0.325,P＜0.001;OR=41.623,95％CI:3.241-534.569,P=0.004).Conclusions Complications after breast reconstruction with abdominal flaps are related to many factors.The surgical risks should be carefully evaluated and personalized plan should be formulated before surgery.
维普
万方数据