Figure 1
Figure 2
Baseline characteristics of study participants_
| Variable | Submammary (n = 40) | Transaxillary (n = 40) | p-value |
|---|---|---|---|
| Age (years), mean ± SD | 48.6 ± 9.2 | 47.8 ± 8.5 | 0.68 |
| Female sex, n (%) | 28 (70.0) | 26 (65.0) | 0.63 |
| BMI (kg/m2), mean ± SD | 24.3 ± 2.8 | 24.0 ± 2.9 | 0.71 |
| NYHA Class III/IV, n (%) | 15 (37.5) | 17 (42.5) | 0.65 |
| LVEF (%), mean ± SD | 56.2 ± 5.1 | 55.8 ± 4.9 | 0.73 |
| Diabetes mellitus, n (%) | 8 (20.0) | 9 (22.5) | 0.79 |
| Hypertension, n (%) | 10 (25.0) | 11 (27.5) | 0.80 |
| Smoking status (Current/Former/Never) | 3 / 6 / 31 | 4 / 5 / 31 | 0.87 |
| FEV1 (% predicted), mean ± SD | 82.4 ± 7.8 | 83.1 ± 8.1 | 0.72 |
| Serum albumin (g/dL), mean ± SD | 3.8 ± 0.4 | 3.7 ± 0.5 | 0.50 |
| CRP (mg/L), mean ± SD | 4.6 ± 1.2 | 4.4 ± 1.3 | 0.52 |
| Breast size category (S/M/L)* | 10/14 / 4 | 11 / 12 / 3 | 0.91 |
| Intercostal space width (cm), mean ± SD | 2.1 ± 0.4 | 2.0 ± 0.5 | 0.33 |
| Chest wall shape (Normal/Barrel/Pectus Excavatum) | 34 / 4 / 2 | 33 / 5 / 2 | 0.88 |
Postoperative pain scores (VAS) at 24, 48, and 72 hours_
| Time point | Submammary (mean ± SD) | Transaxillary (mean ± SD) | p-value |
|---|---|---|---|
| 24 hours | 6.3 ± 1.2 | 5.1 ± 1.0 | <0.001 |
| 48 hours | 5.2 ± 1.1 | 4.4 ± 1.0 | 0.002 |
| 72 hours | 4.5 ± 0.9 | 4.0 ± 0.8 | 0.010 |
| 7 days | 2.8 ± 0.7 | 2.7 ± 0.6 | 0.47 |
Wound healing outcomes (Southampton grades, ASEPSIS scores, and complications)_
| Parameter | Submammary (n = 40) | Transaxillary (n = 40) | p-value |
|---|---|---|---|
| Southampton grade I-II, day seven, n (%) | 34 (85.0) | 37 (92.5) | 0.32 |
| Minor wound complications, n (%) | 5 (12.5) | 3 (7.5) | 0.46 |
| Deep infection, n (%) | 0 (0) | 0 (0) | – |
| ASEPSIS score, mean ± SD | 6.4 ± 1.8 | 6.0 ± 1.6 | 0.29 |
Scar quality (POSAS) and cosmetic satisfaction at three months_
| Parameter | Submammary (n = 40) | Transaxillary (n = 40) | p-value |
|---|---|---|---|
| POSAS total score (observer), mean ± SD | 14.2 ± 3.5 | 17.8 ± 4.2 | < 0.001 |
| Patient-reported cosmetic satisfaction (1–5) | 4.6 ± 0.5 | 4.2 ± 0.6 | 0.004 |
Opioid consumption within first 72 hours (morphine equivalents)_
| Variable | Submammary (n = 40) | Transaxillary (n = 40) | p-value |
|---|---|---|---|
| 0-24 hours | 18 ± 5 | 15 ± 4 | 0.004 |
| 24-48 hours | 16 ± 4 | 13 ± 3 | 0.002 |
| 48-72 hours | 12 ± 3 | 10 ± 3 | 0.006 |
| Total (0-72 hours) | 46 ± 12 | 38 ± 10 | 0.002 |