Combining breast surgery and gynecological surgery is not a good idea

A new study from the Cancer Center at the University of Colorado reveals that it's best that women undergoing both preventive gynecological surgeries and bad surgeries do them separately. The same saying applies to bad reconstruction procedures after a mastectomy.

Often, women who discover that they have cancer in one bad also want to have the other bad removed. When done at the same time as primary surgery, as seems prudent, the complication rate is actually higher, which can double the initial rate. Worse still, the patient may not receive additional treatment for her cancer as soon as she should because of the occurrence of such complications. This delay in treatment may worsen the end result.

Many women who discover a high risk of bad and ovarian cancer choose to undergo bilateral prophylactic mastectomy (preventive removal of both bads) and have their ovaries removed at the same time. Other women whose one or two bads have been removed wish a simultaneous bad reconstruction procedure. Of course, they often think that it will save them time and trouble. Sarah Tevis, researcher and surgeon specializing in bad surgery in her new study report, published in the the Breast journal July 6, 2019.

This study uses data from the National Surgical Quality Improvement Program (NSQIP) database. The researchers examined more than 77,000 bad-operated women between 2011 and 2015.

Of these, 124 had also undergone surgery on their reproductive organs. These tended to be younger and healthier women than the general profile of the group. The researchers wanted to compare the results in women operated on one or more sites to determine which protocol resulted in fewer postoperative complications and a lower readmission rate to the hospital.

The study found that patients whose bads and ovaries were removed at the same time, with or without uterine ablation, or who had undergone a mastectomy with bad reconstruction, required a significantly longer hospital stay. longer, had more complications and needed to be readmitted much more often. and required more second surgeries than women who underwent two or more separate procedures. This is despite the fact that the first group tended to be younger and healthier than those who chose to use combined procedures. Nevertheless, says Tevis, "their rate of complications was higher."

In patients at high risk of bad and ovarian cancer, doctors recommend removal of both bads and the uterus with the ovaries, to reduce the risk of subsequent gynecological cancer. However, says Tevis, "it is safer and easier to do them separately."

In addition to the increased risk of post-surgical complications, the choice of a combined surgery could delay treatment. It is generally more difficult to establish an operation schedule involving surgeons from three different departments, because in this case, bad surgery must also be performed with the help of reconstructive and gynecological surgeons. In addition, the duration of the surgery is much longer, requiring the entire day of operation. This may mean that the surgery is postponed, which worsens the prognosis.

Another important limitation is that chemotherapy after surgery is usually necessary after a mastectomy for bad cancer. When gynecological or plastic bad surgeries are badociated with this operation, the presence of complications may delay the initiation of chemotherapy, further reducing the chances of a successful outcome of cancer treatment.

Although medical factors may in some cases require the combination of these procedures to limit exposure to anesthesia at one time, it is preferable in the vast majority of cases to perform separate surgeries. Tevis summarizes: "Sometimes a patient has a medical problem that makes it preferable, for example, to undergo only one anesthesia. But apart from these rare cases, we recommend separating bad surgery and reconstructive surgery from gynecological surgery. "