scholarly journals A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Hongmei Zheng ◽  
Guodong Zhu ◽  
Qing Guan ◽  
Wei Fan ◽  
Xiang Li ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Immediate Breast Reconstruction ◽  
Cosmetic Outcome ◽  
Latissimus Dorsi Flap ◽  
Latissimus Dorsi Muscle Flap ◽  
Advantages And Disadvantages ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

BackgroundThere are many different methods used for immediate breast reconstruction, but the advantages and disadvantages between distinct methods are not reported and compared directly.MethodsWe collected the data of patients who underwent breast reconstruction from 2010 to 2015 and classified a total of 103 patients into three groups: i) skin- or nipple-sparing mastectomy with implant and partial latissimus dorsi flap (MIPLD); ii) skin- or nipple-sparing mastectomy with the whole latissimus dorsi flap (MWLD); and iii) breast-conserving surgery and partial latissimus dorsi flap (BCSPLD). The outcome, safety, and cosmetic outcome of the latissimus dorsi muscle flap with or without implant were reported and compared.ResultsThe procedures were successful in all cases. None of the patients had severe complications. The 5-year distant metastasis-free survival is 94.2%. All the patients exhibited good arm and back function. Based on the evaluation of the BREAST-Q score, the cosmetic outcome of Satisfaction with Breasts was excellent or good in 97.8% of the cases.ConclusionsMIPLD, MWLD, and BCSPLD stand for three distinct methods for immediate breast reconstruction with good outcome and aesthetic effect. They were safe, were easy to perform, and provided quick recovery and good quality of life. Therefore, these three breast reconstructive methods are worthy of widespread use in clinical practice and provide different ways to reconstruct the breast according to the patients’ conditions and preferences.

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With Robotic Latissimus Dorsi Flap Harvest: Technique and Results

2020 ◽  
pp. 155335062091791
Author(s):  
Gilles Houvenaeghel ◽  
Monique Cohen ◽  
Sandrine Rua Ribeiro ◽  
Julien Barrou ◽  
Mellie Heinemann ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Complication Rate ◽  
Surgical Procedure ◽  
Latissimus Dorsi ◽  
Immediate Breast Reconstruction ◽  
Latissimus Dorsi Flap ◽  
Axillary Lymph ◽  
Grade 3 ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Introduction. Only few cases of robotic latissimus dorsi flap reconstruction (RLDFR) have been reported in indication of reconstruction for breast cancer (BC). We report our experience of combined robotic nipple-sparing mastectomy (R-NSM) and RLDFR, and analyze technique, indications, and reproducibility. Methods. All patients with R-NSM and RLDFR from November 2016 to August 2, 2018, were analyzed, and technics have been described. Complication rate with Clavien-Dindo grading and postoperative hospitalization length (days) are reported. Results. Thirty-five R-NSM with RLDFR were performed in 22 cases for primitive BC and 13 for local recurrence. In 12 patients, another surgical procedure was performed during the same time (axillary lymph node dissection or contralateral breast surgery). R-NSM was realized through a short axillar incision, with inside-only installation for 12 patients (34.3%): 18 nonautologous and 17 autologous RLDFR associated with implant in 9 patients. In logistic regression, mastectomy weight >330 g was significantly associated with the use of implant (odds ratio [OR] = 17, P = .015), and significant factor of the time of anesthesia ≥380 minutes was 2 installations (OR = 10.4, P = .049). The median duration of hospitalization stay was 4 days. Complications rates were 51.4% (18/35; 9 grade-1, 2 grade-2, and 7 grade-3). In logistic regression, associated other surgical procedure was predictive of grade-3 complications (OR = 6.87, P = .053). Conclusion. We confirmed the reproducibility and safety of R-NSM and RLDFR with a decreased complication rate. NSM was performed in 42.8% of our patients after previous radiotherapy. We observed an increase of grade-3 complications when R-NSM and RLDFR was combined to another surgical procedure.

scholarly journals Avaliação da morbidade da área doadora do retalho de Grande Dorsal

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Thiago Pereira de Santana ◽  
Felipe de Souza Serenza ◽  
Fernanda Ruiz de Andrade ◽  
Luis Guilherme Rosifini Alves Rezende ◽  
Amanda Favaro Cagnolati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Muscle Flap ◽  
Latissimus Dorsi Muscle ◽  
Seroma Formation ◽  
Latissimus Dorsi Flap ◽  
Latissimus Dorsi Muscle Flap ◽  
Dorsi Muscle

Introdução: As falhas de cobertura nas extremidades são um grande desafio terapêutico. Dentre as várias opções disponíveis para manejo da cobertura encontra-se o retalho livre do Músculo Grande Dorsal, devido sua grande versatilidade e características anatômicas do pedículo. Objetivo: avaliação da morbidade da área doadora do retalho livre de grande dorsal. Métodos: 7 pacientes avaliados em relação a morbidade da área doadora, seja pelo componente estético, álgico e funcional (amplitude de movimento residual). Resultados: 71,4% dos pacientes repetiriam o mesmo procedimento cirúrgico se necessário. 85,7% indicariam o mesmo procedimento para outros pacientes. Discussão: Devido baixa morbidade da área doadora, o retalho livre de grande dorsal encontra-se uma excelente opção na literatura. Nossos dados corroboram com os resultados apresentados em outros estudos, porém com algumas variações na amplitude de movimento mensurada nos pacientes. Conclusões: Devido grande versatilidade e baixa morbidade na área doadora, o retalho livre de Grande Dorsal é uma excelente opção para falhas de cobertura.Descritores: Retalhos Cirúrgicos; Microcirurgia; Procedimentos Cirúrgicos Reconstrutivos.ReferênciasPederson WC. Nonmicrosurgical coverage of the upper extremity. In: Green´s Operative Hand Surgery. Wolfe SW, Hotchkiss RN, Pederson WC et al. (Org.). 7. Ed. Philadelphia: Elsevier, 2017. cap. 44, p. 1528-1573. v. 2.Jobe MT. Microcirurgia. In: Cirurgia Ortopédica de Campbell. Canale ST (Org.).  10. ed. [S.l.]: São Paulo: Manole, 2006. cap. 60, p. 3287-3371. v. 4.Spear SL, Hess CL. A review of the biomechanical and functional changes in the shoulder following transfer of the latissimus dorsi muscles. Plast Reconstr Surg. 2005;115(7):2070-73.Paolini G, Amoroso M, Pugliese P, Longo B, Santanelli F. Functional sequelae following bilateral mastectomy and immediate reconstruction with latissimus dorsi flap: medium-term follow-up. J Plast Surg Hand Surg. 2014;48(2):99-103.Benditte-Klepetko HC, Lutgendorff F, Kästenbauer T, Deutinger M, van der Horst CM. Analysis of patient satisfaction and donor-site morbidity after different types of breast reconstruction. Scand J Surg. 2014;103(4):249-55.Nagarkar P, Lakhiani C, Cheng A, Lee M, Teotia S, Saint-Cyr M. No-drain DIEP Flap Donor-site Closure Using Barbed Progressive Tension Sutures. Plast Reconstr Surg Glob Open. 2016;4(4):e672.Mannu GS, Qurihi K, Carey F, Ahmad MA, Hussien M. Quilting after mastectomy significantly reduces seroma formation. S Afr j surg.  2015;53(2):50-4.Sajid MS, Betal D, Akhter N, Rapisarda IF, Bonomi R. Prevention of postoperative seroma-related morbidity by quilting of latissimus dorsi flap donor site: a systematic review. Clin Breast Cancer. 2011;11(6):357-63.Lee KT, Mun GH. Fibrin Sealants and Quilting Suture for Prevention of Seroma Formation Following Latissimus Dorsi Muscle Harvest: A Systematic Review and Meta-analysis. Aesthetic Plast Surg. 2015;39(3):399-409.Llewellyn-Bennett R, Greenwood R, Benson JR, English R, Turner J, Rayter Z et al. Randomized clinical trial on the effect of fibrin sealant on latissimus dorsi donor-site seroma formation after breast reconstruction. Br J Surg. 2012; 99(10):1381-1388.Cheng HT, Hsu YC, Wu CI. Quilting sutures, fibrin tissue adhesive or both in reducing the incidence of seroma in the latissimus dorsi flap donor site? An evidence-based analysis. J Plast Reconstr Aesthet Surg. 2014;67(6):881-82.Lee J, Bae Y, Jung JH, Kim WW, Hwang SO, Kwon TJ et al. Effects of Quilting Suture Interval on Donor Site Seromas After Breast Reconstruction With Latissimus Dorsi Muscle Flap: A Randomized Trial. Clin Breast Cancer. 2016;16(6):e159-64.Watanabe K, Morihisa Y, Gotanda K, Kiyokawa K. A case of a chronic expanding hematoma that developed in a latissimus dorsi muscle flap donor site. J Plast Reconstr Aesthet Surg. 2013;66(6):872-74.Pyon JK, Kang BY, Mun GH, Bang SI, Oh KS, Lim SY. Extra-Abdominal Desmoid Tumor in the Donor Site of an Extended Latissimus Dorsi Flap. Arch Plast Surg. 2016;43(1):114-16.Cools AM, De Wilde L, Van Tongel A,  CeyssensC, Ryckewaert R, Cambier DC. Measuring shoulder external and internal rotation strength and range of motion: comprehensive intra-rater and inter-rater reliability study of several testing protocols. J Shoulder Elbow Surg. 2014;23(10):1454-61. Katoh M. Test-retest reliability of isometric shoulder muscle strength measurement with a handheld dynamometer and belt. J Phys Ther Sci. 2015;27(6):1719-22.Celik D, Dirican A, Baltaci G. Intrarater reliability of assessing strength of the shoulder and scapular muscles. J Sport Rehabil. 2012;21(1):1-5.Button J, Scott J, Taghizadeh R, Weiler-Mithoff E, Hart AM. Shoulder function following autologous latissimus dorsi breast reconstruction. A prospective three year observational study comparing quilting and non-quilting donor site techniques. J Plast Reconstr Aesthet Surg. 2010;63(9):1505-12.Lee KT, Mun GH. A systematic review of functional donor-site morbidity after latissimus dorsi muscle transfer. Plast Reconstr Surg. 2014;134(2):303-14.Garusi C, Manconi A, Lanni G, et al. Shoulder function after breast reconstruction with the latissimus dorsi flap: A prospective cohort study - Combining DASH score and objective evaluation. Breast. 2016;27:78-86.

Partial Latissimus Dorsi Muscle Flap With Implant for Immediate Breast Reconstruction

2022 ◽  
Vol 269 ◽  
pp. 134-141
Author(s):  
Hongmei Zheng ◽  
Guodong Zhu ◽  
Xiang Li ◽  
Wei Fan ◽  
Mancheng Yu ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Immediate Breast Reconstruction ◽  
Latissimus Dorsi Muscle ◽  
Latissimus Dorsi Muscle Flap ◽  
Dorsi Muscle

scholarly journals Robotic harvest of a latissimus dorsi flap using a single-port surgical robotic system in breast reconstruction

2021 ◽  
Vol 48 (6) ◽  
pp. 577-582
Author(s):  
Oh Young Joo ◽  
Seung Yong Song ◽  
Dae Hyun Lew ◽  
Hyung Seok Park ◽  
Dong Won Lee
Keyword(s):  
Minimally Invasive ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Single Port ◽  
Immediate Breast Reconstruction ◽  
Robot Assisted ◽  
Invasive Approach ◽  
Robotic Arms ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Robot-assisted surgery is evolving to incorporate a higher number of minimally invasive techniques. There is a growing interest in robotic breast reconstruction that uses autologous tissue. Since a traditional latissimus dorsi (LD) flap leads to a long donor scar, which can be an unpleasant burden to patients, there have been many attempts to decrease the scar length using minimally invasive approaches. This study presents the case of a patient who underwent a robot-assisted nipple-sparing mastectomy followed by immediate breast reconstruction with an LD flap using a single-port robotic surgery system. With the assistance of a single-port robot, a simple docking process using a short and less visible incision is possible. Compared to multiport surgery systems, single-port robots can reduce the possibility of collision between robotic arms and provide a clear view of the medial border of the LD where the curvature of the back restricts the visual field. We recommend the use of single-port robots as a minimally invasive approach for harvesting LD flaps.

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