A comparative study of envelope mastectomy and immediate reconstruction (EMIR) with standard latissimus dorsi immediate breast reconstruction

Abstract Introduction Breast cancer is a devastating disease affecting women of all ages worldwide with the age incidence in Egypt being one decade younger than the mean age incidence, the latissimus dorsi (LD) flap is an important volume-replacement option due to its stability and versatility as an autologous flap. LD flap could be used for total breast reconstruction after mastectomy in selective cases or to fill a large quadrantectomy defect. Aim The aim of this study is to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Patients On 25 patients breast cancer underwent skin-sparing mastectomy with immediate reconstruction using LD flap, Methods All patients were subjected to : (Complete history taken, General examination, Local examination and routine investigations) Surgical procedures 25 patients with breast cancer underwent skin-sparing mastectomy with immediate reconstruction with LD flap. Results Mean age of included patients was 41.12 years with mean BMI 29.17 kg/m2, regarding tumor classification DCIS represented 8% LCIS represented 20% IDC represented 32% ILC represented 40% of all patients, Positive lymph node 1-3 in 40% of patients and more than 3 in 20% of patients and 40% of patients had negative lymph node,96% of patients had no recurrence on the other hand only 4% shows locoregoinal recurrence, Regarding postoperative immediate complications 72% of patients showed no complications. Discussion In the current study we aimed to estimate the oncologic and aesthetic outcomes and the procedure-related complications of latissimus dorsi (LD) flap with skin sparing mastectomy in management of breast cancer. Conclusion Skin sparing mastectomy with immediate breast reconstruction using latissimus dorsi muscular flap allows single-stage, totally autologous reconstruction with a satisfactory aesthetic result, low morbidity, and good quality of life. Recommendations Breast cancer patients are best managed by a multidisciplinary team, Breast conservation surgery does often leave a significant deformity which can best be corrected by an immediate LD flap reconstruction, this method is simple and effective, our concept should be further analyzed in larger comparative studies.

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Comparative study of the prevention of seroma formation in immediate breast reconstruction with latissimus dorsi myocutaneous flaps

Archives of Aesthetic Plastic Surgery ◽

10.14730/aaps.2020.02096 ◽

2020 ◽

Vol 26 (3) ◽

pp. 92-98

Author(s):

Seok Won Hong ◽

Da Woon Lee ◽

Hwan Jun Choi ◽

Eun Soo Park ◽

Jun Hyuk Kim

Keyword(s):

Breast Reconstruction ◽

Comparative Study ◽

Latissimus Dorsi ◽

Immediate Breast Reconstruction ◽

Seroma Formation ◽

Myocutaneous Flaps

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Can Nipple-sparing Mastectomy and Immediate Breast Reconstruction with Modified Extended Latissimus Dorsi Muscular Flap Improve the Cosmetic and Functional Outcome among Patients with Breast Carcinoma?

World Journal of Surgery ◽

10.1007/s00268-007-9046-y ◽

2007 ◽

Vol 31 (6) ◽

pp. 1171-1179 ◽

Cited By ~ 15

Author(s):

Adel Denewer ◽

Omar Farouk

Keyword(s):

Breast Carcinoma ◽

Breast Reconstruction ◽

Functional Outcome ◽

Latissimus Dorsi ◽

Immediate Breast Reconstruction ◽

Muscular Flap ◽

Nipple Sparing Mastectomy ◽

Nipple Sparing

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Accidental latissimus dorsi flap pedicle avulsion during immediate breast reconstruction: Salvage by conversion to free flap

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2012.01.017 ◽

2012 ◽

Vol 65 (8) ◽

pp. 1107-1110 ◽

Cited By ~ 4

Author(s):

A. Martano ◽

C.M. Malata

Keyword(s):

Breast Reconstruction ◽

Free Flap ◽

Latissimus Dorsi ◽

Immediate Breast Reconstruction ◽

Latissimus Dorsi Flap

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Immediate Breast Reconstruction with Latissimus Dorsi Musculo-cutaneous V-D Flap in Breast Conserving Surgery. A New Modified Technique

Acta Scientific Women's Health ◽

10.31080/aswh.2021.03.0235 ◽

2021 ◽

Vol 3 (6) ◽

pp. 112-116

Author(s):

Chaparro Aranguren EA ◽

Rolf Smit ◽

Casas , ◽

Jose Geles

Keyword(s):

Breast Reconstruction ◽

Latissimus Dorsi ◽

Breast Conserving Surgery ◽

Immediate Breast Reconstruction ◽

Modified Technique

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Emotional expectations reported by hospitalized women in southeastern Brazil before being submitted to mastectomy with immediate breast reconstruction: A clinical-qualitative study

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.648 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s507-s507

Author(s):

G.L. Almeida ◽

R.M.C. Sena ◽

V.L.P. Alves ◽

C. Cardoso-Filho ◽

E.R. Turato

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Immediate Breast Reconstruction ◽

University Hospital ◽

Southeastern Brazil ◽

Immediate Reconstruction ◽

Female Population ◽

Competing Interest ◽

Health Assistant ◽

The Aesthetic

IntroductionBreast cancer is a type that more affects female population in the world. Surgical indication, present in most cases, is a mutilating procedure and mentally traumatic for majority of women subjected. Thus, immediate breast reconstruction, which is the choice to rebuild the breast during the mastectomy surgery, is an alternative to reduce discomforts associated with loss of the breast, in addition to being associated potentially with improved emotional and psychosocial quality of life.ObjectiveTo discuss, from psychological viewpoint, the emotional expectations about surgical results of a planned mastectomy with immediate breast reconstruction, reported by women with breast cancer treated in a university hospital in Campinas, state of São Paulo.MethodQualitative design, particularized in the clinical-qualitative method, adequate to health assistant settings, using the semi-directed interview with open-ended questions in-depth, fully transcribed and after submitted to content clinical-qualitative analysis. Intentional sample closed by criterion of information theoretical saturation with 12 sequential participants.ResultsAmongst the emergent categories from free-floating readings, we have chosen the following to presentation:.–The desire of healing above expectations of the aesthetic aspects;–The perception of the surgical approach predominantly with aesthetic effects;–The desire of a contra-lateral healthy breast withdrawal, too.ConclusionsFace the proposal of mastectomy with immediate reconstruction, days before the surgery, women reported to be well emotionally organized for the procedure, although in different ways. This occurs probably due to emotional meanings built by many experiences from their psychological histories, as well as from values provided by the socio-cultural environments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Does Immediate Tissue Expander Placement Increase Immediate Postoperative Complications in Patients with Breast Cancer?

The American Surgeon ◽

10.1177/000313481508100225 ◽

2015 ◽

Vol 81 (2) ◽

pp. 143-149

Author(s):

Hossein Masoomi ◽

Keyianoosh Z. Paydar ◽

Gregory R. D. Evans ◽

Emily Tan ◽

Karen T. Lane ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Hospital Mortality ◽

Breast Reconstruction ◽

Complication Rate ◽

Tissue Expander ◽

The United States ◽

Immediate Breast Reconstruction ◽

Perioperative Outcomes ◽

Immediate Reconstruction

The objectives of this study were to evaluate 1) the rate of immediate breast reconstruction; 2) the frequency of immediate tissue expander placement; and 3) to compare perioperative outcomes in patients who underwent breast reconstruction after mastectomy for breast cancer with immediate tissue expander placement (TE) with those with no reconstruction (NR). Using the Nationwide Inpatient Sample database, we examined the clinical data of patients with breast cancer who underwent mastectomy with or without immediate TE from 2006 to 2010 in the United States. A total of 344,253 patients with breast cancer underwent mastectomy in this period in the United States. Of these patients, 31 per cent had immediate breast reconstruction. We only included patients with mastectomy and no reconstruction (NR: 237,825 patients) and patients who underwent only TE placement with no other reconstruction combination (TE: 61,178 patients) to this study. Patients in the TE group had a lower overall postoperative complication rate (2.6 vs 5.5%; P < 0.01) and lower in-hospital mortality rate (0.01 vs 0.09%; P < 0.01) compared with the NR group. Fifty-three per cent of patients in the NR group were discharged the day of surgery compared with 36 per cent of patients in the TE group. Using multivariate regression analyses and adjusting patient characteristics and comorbidities, patients in the TE group had a significantly lower overall complication rate (adjusted odds ratio [AOR], 0.6) and lower in-hospital mortality (AOR, 0.2) compared with the NR group. The rate of immediate reconstruction is 31 per cent. TE alone is the most common type of immediate reconstruction (57%). There is a lower complication rate for the patients who underwent immediate TE versus the no-reconstruction cohort.

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