Short Transfer of Free Flaps for Breast Reconstruction Using Internal Mammary Artery Perforators as Recipient Vessels: A Prospective Consecutive Case Series

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Ali Ghanem ◽  
Whitney Chow ◽  
Ahid Abood ◽  
Venkat Ramakrishnan
Keyword(s):  
Breast Reconstruction ◽  
Internal Mammary Artery ◽  
Case Series ◽  
Free Flaps ◽  
Consecutive Case ◽  
Internal Mammary

Sampling of Internal Mammary Chain Lymph Nodes during Breast Reconstruction by Free Flaps from the Abdomen

2005 ◽  
Vol 91 (5) ◽  
pp. 415-417 ◽  
Author(s):  
Zoran M Arnez ◽  
Marko Snoj
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Breast Reconstruction ◽  
Internal Mammary Artery ◽  
Treatment Plan ◽  
Free Flaps ◽  
Microvascular Anastomosis ◽  
Internal Mammary Chain ◽  
Free Flap Transfer ◽  
Internal Mammary

The role of internal mammary chain lymph node removal in breast cancer is still not clarified. Although it has been proven that elective dissection of the internal mammary chain nodes does not improve survival, their selective treatment based on sentinel lymph node biopsy is under evaluation. There is another possibility to establish the status of internal mammary chain nodes - sampling of the nodes during the preparation of the site for microvascular anastomosis to the internal mammary artery and vein for free flap transfer. From August 2002 to December 2003, 54 free flaps were performed for breast reconstruction. In 11 cases, an internal mammary chain lymph node was harvested. A positive internal mammary chain node was found in only one case. In this case, the treatment policy was changed by adding irradiation to the internal mammary chain. The sampling of internal mammary chain nodes during preparation of the site for microvascular anastomosis to the internal mammary artery and vein should be a part of the reconstructive procedure after total mastectomy for invasive breast cancer because it could change the treatment plan.

Safety of Coupled Arterial Anastomosis in Autologous Breast Reconstruction

2020 ◽  
Author(s):  
Mariel McLaughlin ◽  
Brooke E. Porter ◽  
Rachel Cohen-Shohet ◽  
Mark M. Leyngold
Keyword(s):  
Breast Reconstruction ◽  
Operating Room ◽  
Retrospective Chart Review ◽  
Free Flaps ◽  
Recipient Site ◽  
Flap Loss ◽  
Increased Risk ◽  
Significant Difference ◽  
Internal Mammary ◽  
Arterial Anastomosis

Abstract Background This study compares the outcomes of coupled versus hand-sewn arterial anastomosis in microvascular breast reconstruction. Methods Retrospective chart review of breast reconstruction free flaps performed between 2013 and 2018 was conducted. Primary end points included flap loss, intraoperative arterial anastomosis revision, and operating room takeback. The decision to couple the arterial anastomosis was based on patient's age, surgeon's preference, history of radiation, and vessel quality. All anastomoses were performed under ×3.5 loupe magnification to internal mammary or thoracodorsal vessels. Results Authors reviewed 104 free flaps; two were lost in hand-sewn group; no flaps were lost in coupled group. There was no significant difference in anastomotic revision rate between coupled and hand-sewn arterial anastomosis (p = 0.186) or return to operating room (OR) between coupled and hand-sewn flaps (p = 1.000). Reasons for takeback included venous congestion and hematoma. Conclusion This study reflects that coupled arterial anastomosis in breast reconstruction may be safely performed without increased risk in anastomotic revision, takeback, or flap loss. Decision to couple should be based on surgeon skill, patient age and history, and assessment of flap and recipient site vasculature.

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