<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0034-7493</journal-id>
<journal-title><![CDATA[Revista Cubana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Cir]]></abbrev-journal-title>
<issn>0034-7493</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0034-74932020000200007</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Reconstrucción mamaria con el uso expansores tisulares]]></article-title>
<article-title xml:lang="en"><![CDATA[Breast reconstruction with the use of tissue expanders]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Wals]]></surname>
<given-names><![CDATA[Lenia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez Vásquez]]></surname>
<given-names><![CDATA[Pedro Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Azaín Ayala]]></surname>
<given-names><![CDATA[María Eugenia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chang Monteagudo]]></surname>
<given-names><![CDATA[Arturo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valdés Guerrero]]></surname>
<given-names><![CDATA[Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ropero Toirac]]></surname>
<given-names><![CDATA[Ramón de Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Oncología y Radiobiología (INOR)  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario &#8220;General Calixto García&#8221;  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Hematología e Inmunología  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>59</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0034-74932020000200007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0034-74932020000200007&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0034-74932020000200007&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La reconstrucción mamaria por cáncer, mediante la técnica de expansión tisular es una técnica que proporciona piel de color, textura y sensibilidad naturales.  Objetivo:  Caracterizar la reconstrucción mamaria con el uso de expansores tisulares en el Instituto Nacional de Oncología y Radiobiología de Cuba.  Método:  Se realizó un estudio retrospectivo y longitudinal en el Servicio de Cirugía Reconstructiva del Instituto Nacional de Oncología y Radiobiología de Cuba del 2013 al 2017. La muestra de 93 pacientes se seleccionó de forma consecutiva del universo de pacientes. El análisis estadístico incluyó las pruebas de Chi-cuadrado, estimación de la razón de momios y regresión logística binaria, con nivel de significación p &#8804; 0,05.  Resultados: Predominó la reconstrucción en mujeres con un promedio de edad de 45,7 años, [IC95% (43,8-47,5) y desviación estándar 9.0]. La quimioterapia se administró a 74 pacientes y la radioterapia a 41. La reconstrucción diferida se realizó en el 51,6 % de las cirugías, y en el 72,0 % no se presentaron complicaciones. El cáncer en estadio III y el uso de quimioterapia y radioterapia neoadyuvante mostraron riesgo con significación estadística para las complicaciones posquirúrgicas.  Conclusiones: La reconstrucción mamaria mediante el uso de expansores tisulares presentó características demográficas y clínicas similares a las descritas previamente en la población cubana y el resto del mundo, aunque con peculiaridades desde el punto de vista onco-reconstructivo. La realización de la cirugía reconstructiva inmediata luego de la radioterapia neoadyuvante resultó en un mayor riesgo de complicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Breast reconstruction for cancer, using the tissue expansion technique, is a technique that provides skin of natural color, texture and sensitivity.  Objective:  To characterize breast reconstruction with the use of tissue expanders at the National Institute of Oncology and Radiobiology of Cuba.  Method:  A retrospective and longitudinal study was carried out in the Reconstructive Surgery Service of the National Institute of Oncology and Radiobiology of Cuba from 2013 to 2017. The sample of 93 patients was selected consecutively from the universe of patients. Statistical analysis included Chi-square tests, estimation of the odds ratio and binary logistic regression, with a significance level of p &#8804; 0.05.  Results:  Reconstruction predominated in women with an average age of 45.7 years, [95% CI (43.8-47.5) and standard deviation 9.0]. Chemotherapy was administered to 74 patients and radiotherapy to 41. Delayed reconstruction was performed in 51.6% of the surgeries, and in 72.0% there were no complications. Stage III cancer and the use of neoadjuvant chemotherapy and radiotherapy showed a statistically significant risk for postoperative complications.  Conclusions:  Breast reconstruction by using tissue expanders presented demographic and clinical characteristics similar to those previously described in the Cuban population and the rest of the world, although with peculiarities from the onco-reconstructive point of view. Performing immediate reconstructive surgery after neoadjuvant radiation therapy resulted in an increased risk of complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[reconstrucción mamaria]]></kwd>
<kwd lng="es"><![CDATA[expansor tisular]]></kwd>
<kwd lng="es"><![CDATA[cáncer de mama]]></kwd>
<kwd lng="en"><![CDATA[breast reconstruction]]></kwd>
<kwd lng="en"><![CDATA[tissue expander]]></kwd>
<kwd lng="en"><![CDATA[breast cancer]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bertozzi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pesce]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Santi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Raposio]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tissue expansion for breast reconstruction Methods and techniques]]></article-title>
<source><![CDATA[Annals of medicine and surgery]]></source>
<year>2017</year>
<volume>21</volume>
<page-range>34-44</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chopra]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hricz]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Brassard]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Orlov]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Holton Iii]]></surname>
<given-names><![CDATA[LH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Two-stage Prosthetic Prepectoral Breast Reconstruction Comparing Tissue Expansion with Carbon Dioxide and Saline]]></article-title>
<source><![CDATA[Plastic and reconstructive surgery Global open]]></source>
<year>2019</year>
<volume>7</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cárdenas]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Mestre]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La reconstrucción mamaria posmastectomía con colgajo miocutáneo de dorsal ancho y expansión tisular]]></article-title>
<source><![CDATA[Rev Cubana Cir]]></source>
<year>2017</year>
<volume>56</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Timman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gopie]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Brinkman]]></surname>
<given-names><![CDATA[JN]]></given-names>
</name>
<name>
<surname><![CDATA[Kleijne]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Seynaeve]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Menke-Pluymers]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Most women recover from psychological distress after postoperative complications following implant or DIEP flap breast reconstruction A prospective long-term follow-up study]]></article-title>
<source><![CDATA[PLoS One]]></source>
<year>2017</year>
<volume>12</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<collab>World Medical Association</collab>
<article-title xml:lang=""><![CDATA[World Medical Association Declaration of Helsinki ethical principles for medical research involving human subjects]]></article-title>
<source><![CDATA[Jama]]></source>
<year>2013</year>
<volume>310</volume>
<numero>20</numero>
<issue>20</issue>
<page-range>2191-4</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Mestre]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Galán]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstrucción mamaria posmastectomía en el Instituto Nacional de Oncología y Radiobiología de Cuba (2008-2012)]]></article-title>
<source><![CDATA[Rev Cubana Cir]]></source>
<year>2014</year>
<volume>53</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<collab>American Society of Plastic Surgeon</collab>
<source><![CDATA[Plastic Surgery Statistics]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pasquale]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Lares]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[GonzáLez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Verdes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mattar]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hollebecq]]></surname>
<given-names><![CDATA[ANA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experiencia en reconstrucción mamaria posterior a la mastectomía en el Instituto de oncologia &amp;raquo;,» &amp;reg;,® &amp;sect;,§ &amp;shy;,­ &amp;sup1;,¹ &amp;sup2;,² &amp;sup3;,³ &amp;szlig;,ß &amp;THORN;,Þ &amp;thorn;,þ &amp;times;,× &amp;Uacute;,Ú &amp;uacute;,ú &amp;Ucirc;,Û &amp;ucirc;,û &amp;Ugrave;,Ù &amp;ugrave;,ù &amp;uml;,¨ &amp;Uuml;,Ü &amp;uuml;,ü &amp;Yacute;,Ý &amp;yacute;,ý &amp;yen;,¥ &amp;yuml;,ÿ &amp;para;,¶ Luis Razetti &amp;raquo;,» &amp;reg;,® &amp;sect;,§ &amp;shy;,­ &amp;sup1;,¹ &amp;sup2;,² &amp;sup3;,³ &amp;szlig;,ß &amp;THORN;,Þ &amp;thorn;,þ &amp;times;,× &amp;Uacute;,Ú &amp;uacute;,ú &amp;Ucirc;,Û &amp;ucirc;,û &amp;Ugrave;,Ù &amp;ugrave;,ù &amp;uml;,¨ &amp;Uuml;,Ü &amp;uuml;,ü &amp;Yacute;,Ý &amp;yacute;,ý &amp;yen;,¥ &amp;yuml;,ÿ &amp;para;,¶ 2000-2004]]></article-title>
<source><![CDATA[Revista Venezolana de Oncología]]></source>
<year>2006</year>
<volume>18</volume>
<page-range>98-102</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sergesketter]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Thomas]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Lane]]></surname>
<given-names><![CDATA[WO]]></given-names>
</name>
<name>
<surname><![CDATA[Orr]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Shammas]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Fayanju]]></surname>
<given-names><![CDATA[OM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decline in Racial Disparities in Postmastectomy Breast Reconstruction A Surveillance, Epidemiology, and End Results Analysis from 1998 to 2014]]></article-title>
<source><![CDATA[Plastic and reconstructive surgery]]></source>
<year>2019</year>
<volume>143</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1560-70</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gibreel]]></surname>
<given-names><![CDATA[WO]]></given-names>
</name>
<name>
<surname><![CDATA[Day]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Hoskin]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Boughey]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Habermann]]></surname>
<given-names><![CDATA[EB]]></given-names>
</name>
<name>
<surname><![CDATA[Hieken]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mastectomy and Immediate Breast Reconstruction for Cancer in the Elderly A National Cancer Data Base Study]]></article-title>
<source><![CDATA[Journal of the American College of Surgeons]]></source>
<year>2017</year>
<volume>224</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>895-905</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[OH]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[McVeigh]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Keane]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lowery]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kerin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neoadjuvant chemoradiation and breast reconstruction the potential for improved outcomes in the treatment of breast cancer]]></article-title>
<source><![CDATA[Irish journal of medical science]]></source>
<year>2019</year>
<volume>188</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>75-83</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cerda]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Vera]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Rada]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Odds ratio: theoretical and practical issues]]></article-title>
<source><![CDATA[Revista medica de Chile]]></source>
<year>2013</year>
<volume>141</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1329-35</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Svee]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sandquist]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Audolfsson]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Folkvaljon]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Isern]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Survival and risk of breast cancer recurrence after breast reconstruction with deep inferior epigastric perforator flap]]></article-title>
<source><![CDATA[The British journal of surgery]]></source>
<year>2018</year>
<volume>105</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1446-53</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sheckter]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Rochlin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kiwanuka]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Curtin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Momeni]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The impact of hospital volume on patient safety indicators following post-mastectomy breast reconstruction in the US]]></article-title>
<source><![CDATA[Breast Cancer Res Treat]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Algara]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Piñero]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Salinas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radioterapia y técnicas de reconstrucción mamaria]]></article-title>
<source><![CDATA[Rev Senol y Patol Mamar]]></source>
<year>2013</year>
<volume>26</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>25-32</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
