scholarly journals Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Jaime Letzkus ◽  
Maria José Del Río ◽  
Carlos Rencoret ◽  
Alejandro Belmar ◽  
Galina Ivanova ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Breast Tumors ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Advancement Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Areola Complex ◽  
Good Cosmetic ◽  
Breast Weight

Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumors located at the superior edge of the upper quadrant or at the upper inner quadrant represent a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a modified Burow's triangle advancement flap for breast-conserving surgery in patients with breast tumors at these locations. This retrospective observational study analyzed 8 out of 213 patients submitted to major oncoplastic breast procedures, who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow's triangle advancement flap. All patients were treated in public and private health systems in Santiago, Chile. The median age at diagnosis was 47 years. The average initial tumor size was 5.9 cm, and the mean excised breast weight was 117 g. Patients required neither symmetrization nor displacement of the nipple-areola complex. Only one patient had a minor complication (wound dehiscence). During follow-up, no local recurrences were reported. We conclude that the modified Burow's triangle advancement flap is a safe and effective technique to manage tumors at this complex location. It provides adequate oncological margins, good cosmetic results, and contralateral symmetry, with complication rates similar to those of standard conservative surgery.

scholarly journals Initial Experience with Simple Oncoplastic Breast Conserving Surgery in Nepal: A Case Report

2020 ◽  
Vol 42 (2) ◽  
pp. 97-99
Author(s):  
Yogendra P Singh ◽  
Suman Khanal
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Outer Quadrant ◽  
Good Cosmetic Outcome ◽  
Node Biopsy ◽  
Areola Complex ◽  
Good Cosmetic

Oncoplastic breast conserving surgery is increasingly used in the management of early breast cancer. Though its use in Nepal is increasing, it is still under-utilized. We present a case of upper outer quadrant early breast cancer located away from nipple-areola complex managed with radial ellipse segmentectomy 10 years back and under regular follow up. We recommend its usage in upper outer quadrant lesions because of its simplicity, access for sentinel lymph node biopsy and good cosmetic outcome.

scholarly journals Dermoglandular Rotation Flaps for Breast-Conserving Therapy: Aesthetic Results, Patient Satisfaction, and Morbidity in Comparison to Standard Segmentectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ursula Hille-Betz ◽  
Bernhard Vaske ◽  
Helga Henseler ◽  
Philipp Soergel ◽  
Sudip Kundu ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Breast Conserving Surgery ◽  
Breast Conserving Therapy ◽  
Outer Quadrant ◽  
Areola Complex ◽  
Aesthetic Results ◽  
Degree Of Satisfaction ◽  
Good Cosmetic ◽  
Treated Breast ◽  
The Relationship

We compared a dermoglandular rotation flap (DGR) in the upper inner, lower inner, and upper outer quadrant regarding similar aesthetic results, patient satisfaction, and comfort after breast-conserving therapy with standard segmentectomy (SE). Between 2003 and 2011, 69 patients were treated with breast-conserving surgery using DGR for cancers with high tumor-to-breast volume ratios or skin resection in the three above mentioned quadrants; 161 patients with tumors in the same quadrants were treated with SE. The outcome of the procedures was assessed at least 7 months after completed radiation therapy using a patient and breast surgeon questionnaire and the BCCT.core software. Symmetry, visibility of the scars, the position of the nipple-areola complex, and the appearance of the treated breast were each assessed on a scale from 1 to 4 by an expert panel and by the patients. Univariate and multivariate analysis were used to evaluate the relationship between patient-, tumor-, and treatment-dependent factors and patient satisfaction. 94.2% of the patients with rotation flaps and 83.5% of the patients with lumpectomy were very satisfied with the cosmetic appearance of their breast. Younger patient age was significantly associated with a lower degree of satisfaction. DGR provides good cosmetic results compared with SE and shows high patient satisfaction despite longer scarring and higher median resection volume.

scholarly journals Retrospective review of 108 breast reconstructions using the round block technique after breast-conserving surgery: Indications, complications, and outcomes

2020 ◽  
Vol 47 (6) ◽  
pp. 574-582
Author(s):  
Seok Kyung In ◽  
Yoon Soo Kim ◽  
Ho Sung Kim ◽  
Jin Hyung Park ◽  
Hong Il Kim ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Breast Conserving Surgery ◽  
Tumor Location ◽  
Breast Volume ◽  
Cosmetic Results ◽  
Major Complications ◽  
Resected Tumor ◽  
Good Cosmetic

Background Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio.Methods All breast reconstructions using the round block technique after BCS were included in this analysis. Patients’ data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated.Results In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation.Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

scholarly journals A new cannula for suction removal of parenchymal tissue of gynaecomastia

2019 ◽  
Vol 6 (12) ◽  
pp. 4388
Author(s):  
Mahesh Siddapura Gangegowda ◽  
Gagan S. Prakash ◽  
Balaji Ramaiah ◽  
Chetan Mali S. M.
Keyword(s):  
Patient Satisfaction ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Bilateral Presentation ◽  
Good Cosmetic ◽  
Clinical Records ◽  
Open Excision ◽  
Glandular Enlargement ◽  
Good Patient Satisfaction

Background: There are various surgical techniques that are available for surgical management of gynecomastia. The aim of the study was to evaluate the cosmetic results and patient satisfaction of a combined liposuction with excision for gynecomastia.Methods: Clinical records of patients affected by gynecomastia referred to our department between between 2015 and 2018 were analyzed, total of 23 patients were included in the study.Results: Overall 23 patients underwent surgery for gynecomastia in the study period, a total of 42 breasts were operated as most of the cases were bilateral in nature. 19 patients had bilateral presentation while 4 patients had unilateral presentation. 35 breasts (80%) were operated with a combined liposuction and excision. Liposuction addresses the fatty gynecomastia whereas open excision is used to remove the glandular enlargement. Four patients underwent excision alone as these patients had a firm retro-areolar lump that was suspicious for malignancy. Another four patients underwent liposuction alone.Conclusions: Surgery is the main stay of management of gynecomastia. Liposuction with excision has had the best outcome with good cosmetic results, acceptable complication rates and good patient satisfaction. 

Day case locked anterior plating for distal radial fractures is safe with uninterrupted antithrombotic therapy

2020 ◽  
pp. 175319342096623
Author(s):  
James A. Morris ◽  
Max Little ◽  
Thomas Ashdown ◽  
Oliver T. Clough ◽  
Timothy Packer ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Complication Rates ◽  
Day Case ◽  
Antithrombotic Treatment ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Excessive Bleeding ◽  
Superficial Wound ◽  
Surgical Fixation ◽  
Anterior Plating

We undertook a matched prospective cohort study over a 4-year period to examine the safety of continuing the administration of regular antithrombotic treatment with warfarin, clopidogrel or aspirin during day case surgical fixation of distal radial fractures. One hundred and one patients were identified and consented to participate in this study. There was only one reported complication: a superficial wound infection treated with antibiotics. No episodes of excessive bleeding were noted intraoperatively. All patients were discharged home on the day of surgery and there were no episodes of readmission, significant bleeding, haematoma requiring intervention, compartment syndrome or wound dehiscence. Complication rates were comparable with those of the matched cohort of patients undergoing the same procedure but who were not taking antithrombotic medications. Level of evidence: IV

scholarly journals Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

2019 ◽  
Vol 101 (1) ◽  
pp. 21-29 ◽  
Author(s):  
M Arnous ◽  
H Elgendy ◽  
W Thabet ◽  
SH Emile ◽  
SA Elbaz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Primary Closure ◽  
Randomised Clinical Trial ◽  
Limberg Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Group I ◽  
Group Ii

BackgroundAlthough several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.MethodsThis was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes.ResultsSixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence.ConclusionsThe Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

scholarly journals Comparison of Snodgross and para-meatal based flap technique for hypospadiasis

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Jaffry S A H ◽  
Naveed Iqbal ◽  
Muhammad Nazir ◽  
Khuda Dad Tarrar
Keyword(s):  
Clinical Intervention ◽  
Wound Dehiscence ◽  
University Hospital ◽  
Flap Technique ◽  
External Meatus ◽  
Good Cosmetic ◽  
Watertight Closure ◽  
The Mean ◽  
Complications Rate

Objective: To compare the two surgical procedures Snod gross & parameatal based flap technique for mid & distal penile hypospadias including cosmosis. Study design: Randomized Clinical interventional trail. Place of study: This study was conducted in the Urology Department of Assir Central University Hospital ABHA, KSA and Department of Urology & Renal transplantation, Jinnah Hospital, Lahore from June 2002 to Dec 2004. Material & Methods: Thirty-two patients were selected for this randomized clinical intervention study with mid shaft & distal hypospadias fulfilling the inclusion criteria. Snod Gross and parameatal based flap technique was assigned randomly to patients comprising of two groups of sixteen each. Watertight closure was made with 6/0 vicryl. Tourniquet or 1:10000 epinephrine were used. Follow up at 2 weeks, three months; 6 months post catheter or stent removal and the patient were assessed on criteria of cosmosis, time for surgery and complications associated with the procedure. Results: Th irty-two patients who underwent procedure of Snodgross & parameatal-based flap in the management of mid shaft & distal penile Hypospadias. Age ranged from 2-12 years. The mean age was 5.23+4 years. The presentation of patients was dystocia of external meatus with misdirected stream in sixteen (50%) patients, spraying of urine in six (25%) and narrow stream in 4(13%) patients. Eighteen patients were having distal penile and fourteen were having mid shaft hypospadias. Following Snod grass technique all patients had good cosmetic results without any complication. Following parameatal based flap, one patients (6.3%) develop wound dehiscence, three patients (18.8%) develop urethral fistula, two patients (12.5%) showed metal retrieval and twenty patients showed good cosmosis. In our study, comparison between Snodgross & parameatal-based flap, the success rate was 100% and 62.4% respectively. Conclusions: Success with Snod gross procedure is better with no complications and good cosmosis. Complications rate was 37.6 % in-patient with para-meatal technique.

No long-term increase in cardiac-related mortality after breast-conserving surgery and radiation therapy using modern techniques.

1998 ◽  
Vol 16 (4) ◽  
pp. 1374-1379 ◽  
Author(s):  
A J Nixon ◽  
J Manola ◽  
R Gelman ◽  
B Bornstein ◽  
A Abner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Treatment Characteristics ◽  
Increased Risk ◽  
Significant Difference ◽  
Related Mortality

PURPOSE To determine whether left-breast irradiation using modern techniques after breast-conserving surgery leads to an increased risk of cardiac-related mortality. METHODS Between 1968 and 1986, 1,624 patients were treated for unilateral stage I or II breast cancer at the Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA, with conservative surgery and breast irradiation. Seven hundred forty-five patients with a potential follow-up of at least 12 years were analyzed. Clinical, pathologic, and treatment characteristics were compared between the 365 patients (49%) who received left-sided irradiation and the 380 patients (51%) who received right-sided irradiation. The relationship between left-sided breast irradiation and the risk of nonbreast cancer- and cardiac-related mortality was examined. RESULTS There was no significant difference in the distribution of clinical, pathologic, or treatment characteristics between the two groups, with the exception of a small difference in pathologic tumor size (medians, left, 2.0 cm, right, 1.5 cm; P = .007). At 12 years, a majority of patients still were alive. Slightly more patients with left-sided tumors had died of breast cancer (31% v 27%; P = NS). Equivalent proportions from each group died of nonbreast cancer causes (11%), including nine patients (2%) from each group who died from cardiac causes. The risk of cardiac mortality did not increase as time after treatment increased for patients who received left-sided irradiation compared with right-sided irradiation. A model that controlled for clinical, pathologic, and treatment differences showed no significant increase in any category of cause of death (breast, cardiac, or other) for patients who received left-sided irradiation. CONCLUSION These results suggest that modern breast radiotherapy is not associated with an increased risk of cardiac-related mortality within at least the first 12 years after treatment.

scholarly journals A modified Fox pentagon technique performed using a polytetrafluoroethylene sling in frontalis suspension to treat blepharophimosis syndrome

2020 ◽  
Vol 103 (1) ◽  
pp. 003685041989388
Author(s):  
Yuan Wang ◽  
Qian Wu ◽  
Li Li ◽  
Wen Liu ◽  
Cheng Li ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Average Score ◽  
Palpebral Fissure ◽  
Cosmetic Results ◽  
Frontalis Suspension ◽  
Good Cosmetic ◽  
Cosmetic Outcomes ◽  
The Mean

The purpose of this study was to evaluate the functional and cosmetic outcomes of a new modified Fox pentagon technique performed using polytetrafluoroethylene in frontalis suspension surgery for blepharophimosis syndrome. This retrospective study enrolled 40 patients diagnosed with blepharophimosis syndrome from March 2016 to October 2018. All patients underwent frontalis suspension using a new modified Fox pentagon technique. The functional and cosmetic outcomes were evaluated. After the operation, the mean palpebral fissure height increased from 2.68 to 6.93 in right eyes and from 2.73 to 6.98 in left eyes. The mean MRD1 increased from 0.53 to 3.76 in right eyes and from 0.50 to 3.78 in left eyes. While preoperative to postoperative differences were statistically significant ( p < 0.01), there were no significant differences between right and left eyes either before or after the surgery ( p > 0.01). All patients achieved good cosmetic results with an average score of 0.6. We have experimentally created a modified Fox pentagon technique performed using a polytetrafluoroethylene sling in a frontalis suspension to treat BPES; this approach yielded favorable cosmetic and functional outcomes.

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