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Postoperative complications in minimally invasive surgery for breast cancer: evaluation by the surgical case record. The number of breast cancer operations conducted laparoscopically has increased considerably in recent years. Although the perioperative morbidity associated with this technique is considerably lower than that associated with conventional surgery, we have found that the documentation of perioperative complications in the surgical case record system is still a problem. In an effort to address this issue, the surgical records of 300 consecutive breast cancer patients who underwent minimally invasive (nipple-sparing) breast cancer surgery were examined retrospectively. Three hundred thirty-seven operations were performed on 299 patients, with a mean follow-up of 5 months (range, 1-34 months). Preoperative, intraoperative, and postoperative complications were documented for each patient. Analysis of the surgical case record revealed that the major complication rate associated with the procedure was 6 percent (17 of 299 patients), with the mean hospital stay for patients in the complication group being 5 days (range, 1-30 days). Complications included wound infection (6 of 299 patients), mastectomy flap necrosis (6 of 299 patients), lymphocele (4 of 299 patients), seroma (3 of 299 patients), and hematoma (2 of 299 patients). The reoperation rate was 4 percent (11 of 299 patients). The major complication rate in this study was slightly higher than that reported by other investigators who have examined laparoscopic breast cancer surgery. In contrast, the reoperation rate in this series was lower than that reported by other investigators, possibly because the surgeon in this series was encouraged to document complications before discharge from the hospital. We conclude that the documentation of perioperative complications in the surgical case record system is still a problem in the field of laparoscopic breast cancer surgery. 7 0 . L e t m ( v ) = 5 * d + 2 x i f r n a z w h s p c o - 5

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