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An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines

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Abstract

Purpose

Perioperative inflammatory cytokines may be related to cancer proliferation, although few studies have investigated this issue in patients undergoing breast reconstruction surgery.

Methods

We conducted a prospective study of patients scheduled for mastectomy only, mastectomy plus deep inferior epigastric perforator flap reconstruction (DIEP), or mastectomy plus tissue expander reconstruction (TE), with or without axial dissection (Ax), for primary breast cancer. Blood samples were collected for analysis of serum IL-6 and VEGF preoperatively, then within 24 h postoperatively (POD 1), and 4–6 days postoperatively (POD 4–6). We investigated the difference in serum cytokine levels over time for each surgical procedure and the difference in serum cytokine levels among the procedures at the three measurement time points.

Results

There were 120 patients included in the final analysis. Serum IL-6 was significantly higher than the preoperative level on POD 1 in patients who underwent mastectomy only, DIEP, or TE and Ax (+), with higher values persisting on POD 4–6 except in those who underwent DIEP. IL-6 was significantly higher after DIEP than after mastectomy only on POD 1, but no differences were observed at POD 4–6. VEGF did not differ significantly among the surgical procedures at any time.

Conclusions

The increase in IL-6 was short term and immediate breast reconstruction is considered a safe procedure.

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Funding

Japan Society for the Promotion of Science, JP 17K17017, 22K10526.

Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Kita-ku, Okayama Prefecture, Japan

    Yuko Mukai & Yoshihiro Kimata

  2. Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital, Kurashiki-City, Okayama Prefecture, Japan

    Naruto Taira

  3. Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan

    Yuko Mukai, Yohei Kitaguchi, Ryoko Nakagiri, Miho Saiga & Yoshihiro Kimata

  4. Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime Prefecture, Japan

    Mariko Kochi

  5. Department of Breast and Endocrine Surgery, Okayama University Hospital, Kita-ku, Okayama Prefecture, Japan

    Naruto Taira, Mariko Kochi, Takayuki Iwamoto, Tadahiko Shien & Hiroyoshi Doihara

  6. Department of Surgery, Kawasaki Medical School General Medical Center, Kurashiki-City, Okayama Prefecture, Japan

    Hiroyoshi Doihara

  7. Department of Plastic Surgery, Okayama Rousai Hospital, 2-10-25 Chikko -Midorimachi, Minami-ku, Okayama-City, Okayama Prefecture, 702-8055, Japan

    Yuko Mukai

Authors
  1. Yuko Mukai
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  2. Naruto Taira
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  3. Yohei Kitaguchi
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  7. Takayuki Iwamoto
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  9. Hiroyoshi Doihara
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  10. Yoshihiro Kimata
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Corresponding author

Correspondence to Yuko Mukai.

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Conflict of interest

Yuko Mukai received a research grand from JSPS KAKENHI Grant Numbers JP 17K17017 and 22K10526. The other authors declare no financial interests in relation to the content of this article.

Ethical approval

This study was approved by the Ethics Committee of Okayama University Hospital (approval no: 1711–029). All procedures involving human participants were performed in accordance with the ethical standards of institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants in the study.

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Mukai, Y., Taira, N., Kitaguchi, Y. et al. An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines. Surg Today 53, 1305–1316 (2023). https://doi.org/10.1007/s00595-023-02700-1

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  • DOI: https://doi.org/10.1007/s00595-023-02700-1

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