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Diep flap surgery

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https://www.readbyqxmd.com/read/28346508/most-women-recover-from-psychological-distress-after-postoperative-complications-following-implant-or-diep-flap-breast-reconstruction-a-prospective-long-term-follow-up-study
#1
Reinier Timman, Jessica P Gopie, J Nick Brinkman, Annelies Kleijne, Caroline Seynaeve, Marian B E Menke-Pluymers, Moniek M Ter Kuile, Aad Tibben, Marc A M Mureau
BACKGROUND: Substantial complication rates after postmastectomy breast reconstruction (BR) in breast cancer patients have been reported. Few studies have reported on the resulting psychological distress (PD) and satisfaction with the aesthetic result in relation to postoperative complications after completion of implant or DIEP flap BR. The present study investigated whether women were able to recover from complication related distress in the long term. METHODS: PD was prospectively measured using questionnaires regarding anxiety, depression and cancer distress...
2017: PloS One
https://www.readbyqxmd.com/read/28255154/immediate-simultaneous-bilateral-breast-reconstruction-with-deep-inferior-epigastric-diep-free-flap-and-transverse-rectus-abdominis-musculocutaneous-tram-pedicled-flap
#2
E J Roslan, E G Kelly, M A Zain, N H Basiron, F H Imran
Breast reconstructive surgery has evolved tremendously since its inception. Following tumour clearance surgery, physical restoration with breast reconstruction is an important aspect of physical and emotional rehabilitation. Various methods have been described to suit patients demand for the best aesthetic outcome. Surgeon's preference, experience and practicality of differing procedures must be considered. We describe a simultaneous bilateral breast reconstruction with free deep inferior epigastric (DIEP) flap and pedicled transverse rectus abdominis musculocutaneous (TRAM) flap immediately post mastectomies for bilateral breast cancers...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28250439/a-retrospective-study-of-lymphatic-transverse-rectus-abdominis-myocutaneous-deep-inferior-epigastric-perforator-flaps-for-breast-cancer-treatment-induced-upper-limb-lymphoedema
#3
Zhuangqing Yang, Sheng Huang, Jiankui Wang, Yan Xi, Xiaojuan Yang, Qi Tang, Juan Du, Jianyun Nie, Tianning Zou, Shaoqing Zhou, Xueliang Tang, Dedian Chen
Breast cancer-related lymphoedema (BCRL) is a common and intractable complication. To evaluate the possible complications of using lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator (TRAM/DIEP) flaps for breast reconstruction and BCRL treatment, 20 patients with moderate or severe BCRL were retrospectively enrolled between November 2012 and October 2014. 10 patients had undergone lymphatic TRAM/DIEP flap surgery were assigned to the surgery group. 10 patients unwilling to undergo reconstruction were assigned to the physiotherapy group treated with traditional physical therapy...
December 2017: Scientific Reports
https://www.readbyqxmd.com/read/28229288/complications-in-diep-flap-breast-reconstruction-after-mastectomy-for-breast-cancer-a-prospective-cohort-study-comparing-unilateral-versus-bilateral-reconstructions
#4
Ryckie G Wade, Sergio Razzano, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
BACKGROUND: The demand for bilateral breast reconstructions is rising worldwide. In the UK, approximately 30% of breast cancer patients undergoing mastectomy choose autologous tissue breast reconstruction. Although the deep inferior epigastric perforator (DIEP) flap is gaining popularity, bilateral DIEP flap breast reconstruction remains a complex procedure and reliable outcome data are lacking. In the absence of clinical trials, evidence from cohort studies is needed to better inform clinicians and patients...
February 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#5
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28122466/blood-loss-and-duration-of-surgery-are-independent-risk-factors-for-complications-after-breast-reconstruction
#6
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Albert Modin, Richard Lewin, Anna Elander, Hans Mark
BACKGROUND: Complications after breast reconstructive surgery are common, and they can be caused by a wide range of factors. The aim of the present study was to identify independent perioperative risk factors for postoperative complications after breast reconstruction. METHODS: A retrospective study was performed of 623 consecutive breast cancer patients who had undergone deep inferior epigastric perforator (DIEP) flap, latissimus dorsi (LD) flap, lateral thoracodorsal flap (LTDF), or tissue expander with secondary implant (EXP)...
January 26, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#7
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28059854/perforator-phase-contrast-angiography-of-deep-inferior-epigastric-perforators-a-better-preoperative-imaging-tool-for-flap-surgery-than-computed-tomographic-angiography
#8
Xiangyu Yang, Michael J Miller, Harry T Friel, Allison Slijepcevic, Michael V Knopp
OBJECTIVE: The aim of this study was to demonstrate the feasibility of in vivo perforator visualization by a newly proposed magnetic resonance-based perforator phase contrast angiography (pPCA) technique for deep inferior epigastric perforator (DIEP) flap surgery and to prospectively compare its image quality and clinical value with computed tomographic angiography (CTA), the state-of-the-art perforator imaging technique. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained...
January 4, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28029602/use-of-both-antegrade-and-retrograde-internal-mammary-vessels-in-the-bipedicled-deep-inferior-epigastric-perforator-flap-for-unilateral-breast-reconstruction
#9
Jonatan Hernandez Rosa, Rami D Sherif, Philip J Torina, Marco A Harmaty
BACKGROUND: Autologous abdominal tissue transfer is a well-established method of breast reconstruction. The deep inferior epigastric perforator (DIEP) flap has the additional benefit of minimal donor site morbidity as it spares the muscle and fascia. Conventional DIEP flaps may not provide adequate volume in cases where the patient is thin, has midline abdominal scars, and/or has a large volume of tissue to replace. One solution is to use a bipedicled DIEP flap, incorporating all the available abdominal tissue...
January 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27798949/impact-of-time-interval-between-radiation-and-free-autologous-breast-reconstruction
#10
Aaron B Mull, Ali A Qureshi, Ema Zubovic, Yuan J Rao, Imran Zoberi, Ketan Sharma, Terence M Myckatyn
Background To evaluate whether the timing of surgery after radiation in autologous breast reconstruction affects major complications. Methods We performed a retrospective review of 454 free flaps (331 patients) for breast reconstruction at a single institution from 2003 to 2014. Charts were reviewed for age, BMI, laterality, flap type (TRAM, msTRAM, DIEP), surgeon, donor vessels (IMA, TD), chemotherapy, smoking, diabetes, hypertension, DVT, venous anastomoses, vein size, and time from radiation (none, < 12 months, or ≥ 12 months)...
February 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27622090/predictors-of-reoperations-in-deep-inferior-epigastric-perforator-flap-breast-reconstruction
#11
Dmytro Unukovych, Camilo Hernandez Gallego, Helena Aineskog, Andres Rodriguez-Lorenzo, Maria Mani
BACKGROUND: The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure. PATIENTS AND METHODS: A retrospective study of consecutive patients undergoing DIEP breast reconstruction 2007 to 2014 was performed and included a review of 433 medical charts...
August 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27579248/diep-flap-for-breast-reconstruction-using-epidural-anesthesia-with-the-patient-awake
#12
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27542592/contralateral-breast-symmetrisation-in-unilateral-diep-flap-breast-reconstruction
#13
Ryckie G Wade, Francesco Marongiu, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
INTRODUCTION: Women undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction may be offered a contralateral symmetrisation either at the time of reconstruction (simultaneous/immediate) or at a later stage (delayed). Simultaneous contralateral breast symmetrisation may be more beneficial to patients and healthcare institutions by avoiding staged surgery, although there is limited evidence on which to base practice. This deficit formed the rationale for our study...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27464608/postmastectomy-reconstruction-outcomes-after-intraoperative-evaluation-with-indocyanine-green-angiography-versus-clinical-assessment
#14
Gustave K Diep, Jane Yuet Ching Hui, Schelomo Marmor, Bruce L Cunningham, Umar Choudry, Pamela R Portschy, Todd M Tuttle
BACKGROUND: Mastectomy flap necrosis is a major complication in patients undergoing tissue expander-based reconstruction. This study compared the complication rates following mastectomy and immediate reconstruction with intraoperative indocyanine green (ICG) angiography evaluation to those with clinical assessment only. METHODS: We performed a single-institution retrospective study of mastectomy patients who underwent immediate tissue expander-based reconstruction between September 2009 and December 2013...
November 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27411505/erratum-to-failed-pneumoperitoneum-for-laparoscopic-surgery-following-autologous-deep-inferior-epigastric-perforator-diep-flap-breast-reconstruction-a-case-report
#15
Daniel M Balkin, Quan-Yang Duh, Gabriel M Kind, David S Chang, Mary H McGrath
No abstract text is available yet for this article.
2016: BMC Surgery
https://www.readbyqxmd.com/read/27391834/the-profunda-artery-perforator-flap-experience-for-breast-reconstruction
#16
Robert J Allen, Z-Hye Lee, James L Mayo, Joshua Levine, Christina Ahn, Robert J Allen
BACKGROUND: The profunda artery perforator flap was first introduced for breast reconstruction in 2010. In this article, the authors analyze the results of all profunda artery perforator flaps performed by their group to date. METHODS: A retrospective review was completed of consecutive profunda artery perforator flaps performed by the senior author (R.J.A.) from 2010 to 2014. Patient demographics, indications, operative techniques, flap specifics, complications, and number of operations were recorded...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27350267/abdominal-morbidity-after-single-versus-double-pedicled-deep-inferior-epigastric-perforator-flap-use
#17
Hirokazu Uda, Yoko Katsuragi Tomioka, Syunji Sarukawa, Ataru Sunaga, Hideaki Kamochi, Yasusih Sugawara, Kotaro Yoshimura
BACKGROUND AND AIM: The reduced incidence of donor site morbidity after deep inferior epigastric perforator (DIEP) flap is because the rectus muscle and its fascia are preserved. However, no study has proved that trunk flexion recovers not by the compensatory effect of the contralateral rectus muscle but by reinnervation of the ipsilateral rectus muscle. We hypothesized that if sufficient reinnervation occurs, patients who undergo single-pedicled DIEP (S-DIEP) flap or double-pedicled DIEP (D-DIEP) flap breast reconstruction would have similar levels of preoperative trunk flexion...
September 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27125256/smoking-increases-donor-site-complications-in-breast-reconstruction-with-diep-flap
#18
Stina Klasson, Johan Nyman, Henry Svensson, Patrik Velander
OBJECTIVE: Reconstruction with deep inferior epigastric perforator flap (DIEP) is considered to be the first choice for autologous breast reconstruction. The primary aims of this retrospective study were to find out if differences in smoking habits and BMI are useful predictors for postoperative complications in DIEP surgery. METHODS: Three hundred and one patients were included. Data regarding smoking habits, BMI, age at surgery, total and final flap weight, abdominal scars, parity, number of perforators, chemotherapy, post mastectomy radiation therapy, and preoperative mapping of perforators with either Computer Tomography Angiography or hand-held ultra sound Doppler were collected...
December 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27120999/failed-pneumoperitoneum-for-laparoscopic-surgery-following-autologous-deep-inferior-epigastric-perforator-diep-flap-breast-reconstruction-a-case-report
#19
Daniel M Balkin, Quan-Yang Duh, Gabriel M Kind, David S Chang, Mary H McGrath
BACKGROUND: Laparoscopic abdominal surgery may prove difficult in patients who have undergone previous abdominal procedures. No reports in the medical literature have presented an aborted laparoscopic procedure for failed pneumoperitoneum following autologous flap-based breast reconstruction. CASE PRESENTATION: A 55-year-old woman presented with recurrent invasive lobular carcinoma of the right breast as well as a history of ductal carcinoma in situ of the left breast...
April 27, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27069312/diep-flap-salvage-by-cannula-venesection-of-the-superficial-inferior-epigastric-vein
#20
Puttan Wongtriratanachai, Abbe Michelle Martin, Kongkrit Chaiyasate
The deep inferior epigastric perforator (DIEP) flap is a technique of autologous breast reconstruction that is gaining popularity. The main advantage of the DIEP flap over the traditional transverse rectus abdominis myocutaneous (TRAM) flap is that there is a lower incidence of abdominal wall donor-site morbidity with the DIEP flap. However, venous congestion is the most dreaded complication of DIEP flap surgery which requires prompt intervention. In this case report, we present a simple but effective procedure to salvage the congested DIEP flap...
2016: European Journal of Plastic Surgery
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