LICAP Versus TDAP for Reconstruction of Partial Breast Defects

BackgroundPerforator flaps are the latest development in reconstructive surgery. Pedicled chest wall perforator flaps can be utilized in many cases of partial breast reconstruction. This research compares the outcome and technique of Thoracodorsal Artery Perforator Flap (TDAP) and the Lateral Intercostal Artery Perforator Flap (LICAP) in reconstruction of partial breast defects.MethodsPatient records were reviewed for the time period between 2011-2019 at the breast unit of the National Cancer Institute of Cairo University. Eighty three patients were accessible for the study. (46 cases of TDAP flap and 37 cases of LICAP flap). Relevant clinical data were extracted from patients’ records. A special visit was organized for all 83 patients ,where a digital photograph was taken in an antro-posterior view. The photographs were later processed via BCCT.core software to obtain an objective cosmetic outcome assessment.ResultsComplication rates and cosmetic outcome were comparable for both techniques. TDAP flap flap proved to require more tedious dissection and preoperative Doppler mapping to localize perforator vessels. On the other hand LICAP was technically easier with more consistent perforators.ConclusionPedicled chest wall perforator flaps constitute an excellent reconstructive option in partial breast defects. They have replaced musculocutaneous flaps to a large extent.

Thoracodorsal Artery Perforator Flap for Chronic Radiation-Induced Ulcer of the Axilla in Vietnam

Breast cancer is the leading cause of death in females worldwide. Radiotherapy plays an important role for locoregional control in the comprehensive management of breast cancer. Chronic radiation-induced ulcer of the axilla can occur, and it is complicated to treat for these lesions. The application of a thoracodorsal artery perforator flap offers many advantages to be one of the most efficient treatments for radiation-induced ulcers of the axillary region. We introduce a series of 5 patients with radiation-induced ulcers of the axilla treated by using a thoracodorsal artery perforator flap. The mean operative time was 190 minutes. During at least a two-year follow-up, no complication has been found, and the patient has achieved good cosmetic result without movement limitation of the upper limb.

The role of thoracodorsal artery perforator flap after breast conserving surgery

Background: The emergence of thoracodorsal artery perforator flap combined with radiotherapy as new techniques in breast reconstruction has resulted in greater focus on oncoplastic breast surgery. In this study, were to study the role of thoracodorsal artery perforator flap after breast conserving surgery.Methods: This study included 40 patients of stage I and II breast cancer at Menoufia University hospital from July 2018 to February 2019. Every patient accepted to be enrolled in thus study with curative intent by having breast conservative surgery and immediate reconstruction by TDAP flap.Results: The mean operative time was 145 min. Seroma is the commonest complication following TDAP flap reconstruction and occurred in four cases (20%) and was treated by repeated aspiration. The cosmetic outcome was acceptable with 90% of patients rating their outcome as either pleased or satisfied. The subjectively assessed functional outcome showed a mean time of 10 days postoperative for patients to regain their full range of shoulder movements.Conclusions: Thoracodorsal artery perforator flap can play a significant role in oncoplastic surgery and breast reconstruction with acceptable cosmetic and functional outcome.