Bilateral breast reduction surgery in England: a postcode lottery

Wraight, William M.; Tay, Sherilyn; Nduka, Charles; Pereira, John

doi:10.1016/j.bjps.2007.03.002

Cited by 32 publications

(26 citation statements)

References 42 publications

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“…For example, a survey of funding criteria for RM conducted in the United Kingdom by 303Trust in 2007 revealed that 198 of 245 respondents specified a maximum BMI (range 25e32) as an exclusion criterion. 7 Although several articles 8e12 report that these patients showed significant improvements in the quality of life after breast reduction to the same extent as those who were of normal weight, there is a lack of specifically designed studies for the particular purpose of evaluating the effect of RM on obese patients.…”

Section: Introductionmentioning

confidence: 98%

Impact of reduction mammoplasty on the quality of life of obese patients suffering from symptomatic macromastia: A descriptive cohort study

Hernánz

Fidalgo

Muñoz

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Introductionmentioning

confidence: 98%

Impact of reduction mammoplasty on the quality of life of obese patients suffering from symptomatic macromastia: A descriptive cohort study

Hernánz

Fidalgo

Muñoz

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Given continued national trends of increasing BMI, clarifying the effect of obesity on surgical complications is now more important than ever [14,15]. A population-wide analysis would more definitively establish whether an association exists between obesity and early postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

Obesity and early complications following reduction mammaplasty: An analysis of 4545 patients from the 2005–2011 NSQIP datasets

Nelson

Fischer

Chung

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Reduction mammoplasty is a proven treatment for symptomatic macromastia, but the association between obesity and early postoperative complications is unclear. The purpose of this study was to perform a population level analysis in an effort to determine the impact of obesity on early complications after reduction mammaplasty. This study examined the 2005-2011 NSQIP datasets and identified all patients who underwent reduction mammoplasty. Patients were then categorised according to the World Health Organisation obesity classification. Demographics, comorbidities, and perioperative risk factors were identified among the NSQIP variables. Data was then analysed for surgical complications, wound complications, and medical complications within 30 days of surgery. In total, 4545 patients were identified; 54.4% of patients were obese (BMI > 30 kg/m(2)), of which 1308 (28.8%) were Class I (BMI = 30-34.9 kg/m(2)), 686 (15.1%) were Class II (BMI = 35-39.9 kg/m(2)), and 439 (9.7%) were Class III (BMI > 40 kg/m(2)). The presence of comorbid conditions increased across obesity classifications (p < 0.001), with significant differences noted in all cohort comparisons except when comparing class I to class II (p = 0.12). Early complications were rare (6.1%), with superficial skin and soft tissue infections accounting for 45.8% of complications. Examining any complication, a significant increase was noted with increasing obesity class (p < 0.001). This was further isolated when comparing morbidly obese patients to non-obese (p < 0.001), class I (p < 0.001), and class II (p = 0.01) patients. This population-wide analysis - the largest and most heterogeneous study to date - has demonstrated that increasing obesity class is associated with increased early postoperative complications. Morbidly obese patients are at the highest risk, with complications occurring in nearly 12% of this cohort.

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“…5,6,10 Few investigators have examined the potential inequality of provision at a truly local level within one region. Inequalities in access to healthcare services have previously caused conflict between patients and healthcare HEPATOBILIARY SURGERY Ann R Coll Surg Engl 2010; 92: 225-230 …”

mentioning

confidence: 99%

“…4 The so-called 'postcode' provision of healthcare services and treatments in the UK has been investigated and highlighted across a range of medical specialities. [5][6][7][8][9][10] However, the majority of these studies have been conducted on a national level, subdividing populations into either strategic health authorities, primary care trusts or medical specialty. 5,6,10 Few investigators have examined the potential inequality of provision at a truly local level within one region.…”

mentioning

confidence: 99%

“…[5][6][7][8][9][10] However, the majority of these studies have been conducted on a national level, subdividing populations into either strategic health authorities, primary care trusts or medical specialty. 5,6,10 Few investigators have examined the potential inequality of provision at a truly local level within one region. Inequalities in access to healthcare services have previously caused conflict between patients and healthcare CONCLUSIONS Introduction of a referral protocol standardised resection rates from the four district hospitals, but these remain lower compared to the specialist centre.…”

mentioning

confidence: 99%

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Evaluation of the introduction of a standardised protocol for the staging and follow-up of colorectal cancer on resection rates for liver metastases

Tiernan

Briggs

Irving

et al. 2010

annals

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Ann R Coll Surg Engl 2010; 92: [225][226][227][228][229][230] 225 Despite significant advances in cancer treatment over the past decade, colorectal cancer (CRC) remains a major source of cancer-related mortality, being the second commonest malignancy in the UK and accounting for 10% of all cancer-related deaths.1 The majority of these deaths result from the development of metastatic disease. Approximately one-third of patients with CRC present with synchronous liver or lung metastases, with a further 8-25% developing metachronous disease following primary tumour resection.2,3 Changes in surgical and radiological techniques, in addition to new chemotherapeutic regimens, now enable patients with advanced disease, whose only option in the past would have been palliation, to be considered for potentially curative treatment. 4The so-called 'postcode' provision of healthcare services and treatments in the UK has been investigated and highlighted across a range of medical specialities.5-10 However, the majority of these studies have been conducted on a national level, subdividing populations into either strategic health authorities, primary care trusts or medical specialty. 5,6,10 Few investigators have examined the potential inequality of provision at a truly local level within one region. Inequalities in access to healthcare services have previously caused conflict between patients and healthcare HEPATOBILIARY SURGERY Ann R Coll Surg Engl 2010; 92: 225-230

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Bilateral breast reduction surgery in England: a postcode lottery

Cited by 32 publications

References 42 publications

Impact of reduction mammoplasty on the quality of life of obese patients suffering from symptomatic macromastia: A descriptive cohort study

Impact of reduction mammoplasty on the quality of life of obese patients suffering from symptomatic macromastia: A descriptive cohort study

Obesity and early complications following reduction mammaplasty: An analysis of 4545 patients from the 2005–2011 NSQIP datasets

Evaluation of the introduction of a standardised protocol for the staging and follow-up of colorectal cancer on resection rates for liver metastases

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