Annals of Surgical Oncology

, Volume 24, Issue 3, pp 816–822

Prior Radiotherapy Does Not Affect Abdominal Wall Reconstruction Outcomes: Evidence from Propensity Score Analysis

  • Salvatore Giordano
  • Patrick B. Garvey
  • Donald P. Baumann
  • Jun Liu
  • Charles E. Butler
Reconstructive Oncology

DOI: 10.1245/s10434-016-5603-7

Cite this article as:
Giordano, S., Garvey, P.B., Baumann, D.P. et al. Ann Surg Oncol (2017) 24: 816. doi:10.1245/s10434-016-5603-7
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ABSTRACT

Background

Prior abdominal wall radiotherapy (XRT) adversely affects wound healing, but data are limited on how prior XRT may affect abdominal wall reconstruction (AWR) outcomes. The purpose of this study was to determine whether prior abdominal wall radiotherapy is associated with a higher incidence of complications following AWR for a hernia or oncologic resection defect.

Methods

We performed a retrospective study of consecutive patients who underwent complex AWR using acellular dermal matrix (ADM) at a single center. We compared outcomes between patients who underwent prior XRT that directly involved the abdominal wall and those who did not receive XRT. Propensity score match-paired and multivariate analyses were performed.

Results

A total of 511 patients (130 [25.4 %] with prior XRT; 381 [74.6 %] without prior XRT) underwent AWR with ADM for repair of a complex hernia or oncologic resection defect. Mean follow-up was 31.4 months, mean XRT dose was 48.9 Gy, and mean time between XRT and reconstruction was 19.2 months. XRT AWR patients underwent more flap reconstructions (14.6 vs. 5.0 %, P < 0.001) but fewer component separations (61.5 vs. 71.4 %; P = 0.036) than non-XRT AWR patients. The two groups had similar rates of hernia recurrence (8.5 vs. 9.4 %; P = 0.737) and surgical site occurrence (25.4 vs. 23.4 %; P = 0.640). In the propensity score-matched subgroups, there were no differences in hernia recurrence, surgical site occurrence, and wound healing complication rates.

Conclusions

Prior XRT does not adversely affect outcomes in AWR. However, surgeons should be aware of the higher likelihood of needing a soft tissue flap reconstruction for soft tissue replacement when performing AWR after XRT.

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Salvatore Giordano
    • 1
  • Patrick B. Garvey
    • 1
  • Donald P. Baumann
    • 1
  • Jun Liu
    • 1
  • Charles E. Butler
    • 1
  1. 1.Department of Plastic SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA