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Latissimus dorsi flap breast reconstruction

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https://www.readbyqxmd.com/read/28917935/trends-in-post-mastectomy-breast-reconstruction-types-at-a-breast-cancer-tertiary-referral-centre-before-and-after-introduction-of-acellular-dermal-matrices
#1
Hadyn K N Kankam, George J M Hourston, Laura J Fopp, John R Benson, Sarah L Benyon, Michael S Irwin, Amit Agrawal, Parto Forouhi, Charles M Malata
BACKGROUND: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution. METHODS: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs...
August 31, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28882492/assessing-the-effort-associated-with-teaching-residents
#2
Kelli R Aibel, Tracy Truong, Ronnie L Shammas, Eugenia H Cho, Kate J Buretta, Gina-Maria Pomann, Scott T Hollenbeck
BACKGROUND: Intraoperative resident education is an integral mission of academic medical centers and serves as the basis for training the next generation of surgeons. The actual effort associated with teaching residents is unknown as it pertains to additional operative time. Using a large validated multi-institutional dataset, this study aims to quantify the effect of having a resident present in common plastic surgery procedures on operative time. Future directions for developing standardized methods to record and report teaching time are proposed, which can help inform prospective studies...
August 5, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28876635/the-surgical-management-of-central-breast-tumours-at-a-specialist-breast-unit-in-johannesburg-south-africa
#3
L Van Schalkwyk, C A Benn, K Bergstrom
BACKGROUND: Central breast tumours are defined as tumours in the retroareolar area, or within 1.5-2.0 cm from the areolar edge. In the past, breast conservation therapy (BCT) for central breast tumours was considered controversial due to concerns regarding oncologic safety and cosmesis. Recent evidence does however suggest that oncoplastic techniques offer a cosmetically acceptable and safe alternative to mastectomy in these tumours. METHOD: Patients with central breast tumours (invasive and in situ) were identified from a breast cancer database of 431 patients who presented to the Netcare Breast Care Centre in Johannesburg over a one-year period (June 2015-June 2016)...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28861376/patient-determinants-as-independent-risk-factors-for-postoperative-complications-of-breast-reconstruction
#4
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Mattias Lidén, Anna Elander, Hans Mark
BACKGROUND: Breast reconstruction is an essential component in the treatment of breast cancer. Postoperative complications after breast reconstruction are common and affect patient satisfaction. Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. METHODS: We retrospectively enrolled 623 consecutive patients who underwent reconstruction with a deep inferior epigastric perforator flap (DIEP), latissimus dorsi flap (LD), lateral thoracodorsal flap (LTDF), or tissue expander with a secondary implant (EXP) in this study...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28854081/treatment-of-axillary-web-syndrome-using-instrument-assisted-soft-tissue-mobilization-and-thoracic-manipulation-for-associated-thoracic-rotation-dysfunction-a-case-report
#5
Patricia Crane, Jaclyn Ladden, Danielle Monica
PURPOSE: There is a paucity of research that investigates physical therapy management for patients with axillary web syndrome (AWS) and thoracic rotation dysfunction. The purpose of this case report is to describe the management of a patient with AWS and thoracic rotation dysfunction using an impairment-based approach that includes instrument assisted soft tissue mobilization (IASTM), thoracic manipulation, and stretching. CASE DESCRIPTION: The patient was a 48-year-old female with a past medical history of bilateral breast cancer with a bilateral latissimus dorsi flap reconstruction...
August 30, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28833134/changes-in-shoulder-muscle-activity-pattern-on-surface-electromyography-after-breast-cancer-surgery
#6
Eun Joo Yang, YoungOk Kwon
BACKGROUND AND OBJECTIVES: Alterations in muscle activation and restricted shoulder mobility, which are common in breast cancer patients, have been found to affect upper limb function. The purpose of this study was to determine muscle activity patterns, and to compare the prevalence of abnormal patterns among the type of breast surgery. METHODS: In total, 274 breast cancer patients were recruited after surgery. Type of breast surgery was divided into mastectomy without reconstruction (Mastectomy), reconstruction with tissue expander/implant (TEI), latissimus dorsi (LD) flap, or transverse rectus abdominis flap (TRAM)...
August 22, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28831362/autologous-latissimus-dorsi-breast-reconstruction-flap-salvage-microvascular-anastomosis-with-serratus-branch
#7
Victoria Kuta, Martin LeBlanc
Autologous breast reconstruction has become a standard option during the recovery of breast cancer survivors. Although pedicle damage is a rare complication of this procedure, extensive torsion or tension can lead to partial or total flap failure. We report a case of partial flap salvage after accidental transection of the pedicled blood supply within the intramuscular course of a latissimus dorsi musculocutaneous flap. This salvage technique involved microvascular anastomosis between the remaining vasculature of the latissimus dorsi pedicle and the serratus branch of the thoracodorsal artery and vein...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28802886/-lumbar-artery-perforator-flap-for-breast-reconstruction
#8
J-F Honart, N Leymarie, B Sarfati, H Alknashnam, K Rem, F Rimareix, F Kolb
Even though DIEP-SIEA flaps or latissimus dorsi musculocutaneous flap are the most frequently used, a wide variety of flaps have been described for autologous breast reconstruction. Concerning the choice of donor-site, the aim is to prevent and to limit the morbidity. That is why the donor-site should be carefully chosen, according to the morphology of the patient. Lumbar artery perforator flap (LAP) is an option for breast reconstruction, but it is not well known and its use is limited. This study summarizes the authors' early experience with free LAP flap for breast reconstruction...
August 9, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28801298/-application-of-3d-visualization-technique-in-breast-cancer-surgery-with-immediate-breast-reconstruction-using-laparoscopically-harvested-pedicled-latissimus-dorsi-muscle-flap
#9
Pu-Sheng Zhang, Li-Kun Wang, Yun-Feng Luo, Fu-Jun Shi, Lin-Yun He, Cheng-Bing Zeng, Yu Zhang, Chi-Hua Fang
OBJECTIVE: To study the value of 3D visualization technique in breast-preserving surgery for breast cancer with immediate breast reconstruction using laparoscopically harvested pedicled latissimus dorsi muscle flap. METHODS: From January, 2015 to May, 2016, 30 patients with breast cancer underwent breast-preserving surgery with immediate breast reconstruction using pedicled latissimus dorsi muscle flap. The CT data of the arterial phase and venous phase were collected preoperatively and imported into the self-developed medical image 3D visualization system for image segmentation and 3D reconstruction...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28740762/long-term-health-related-quality-of-life-after-breast-reconstruction-comparing-4-different-methods-of-reconstruction
#10
Andri Thorarinsson, Victoria Fröjd, Lars Kölby, Johan Ljungdal, Charles Taft, Hans Mark
BACKGROUND: Studies have confirmed that breast reconstruction is beneficial to improve health-related quality of life (HR-QoL) in breast cancer patients. Our aim was to compare 4 different methods of breast reconstruction on patient satisfaction and HR-QoL using both general and specific patient-reported outcome instruments. METHODS: Retrospectively, 459 patients who underwent breast reconstruction with a deep inferior epigastric artery perforator (DIEP) flap, latissimus dorsi flap, lateral thoracodorsal flap, or expander with secondary implant and who had responded to the questionnaires were enrolled...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28734752/long-term-effect-of-oncoplastic-breast-conserving-surgery-using-latissimus-dorsi-miniflaps-on-mammographic-surveillance-and-the-detection-of-local-recurrence
#11
S Mele, D Wright, N Paramanathan, S Laws, L Peiris, R Rainsbury
INTRODUCTION: Latissimus dorsi miniflap is a breast-conserving volume replacement technique for the reconstruction of large breast defects. While mammographic features of miniflap reconstruction have been described, little is known about the incidence, mode of presentation and size of local recurrence after this procedure. This study aimed to investigate the impact of latissimus dorsi miniflap reconstruction on the frequency, presentation and detection of local recurrence. METHODS: Clinical, radiological and pathological data were reviewed in 261 patients...
September 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28728326/the-role-of-negative-pressure-wound-therapy-in-latissimus-dorsi-flap-donor-site-seroma-prevention-a-cohort-study
#12
Apichai Angspatt, Thana Laopiyasakul, Pornthep Pungrasmi, Poonpissamai Suwajo
BACKGROUND: Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. METHODS: In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28676319/impact-of-adjuvant-anti-estrogen-therapies-tamoxifen-and-aromatase-inhibitors-on-perioperative-outcomes-of-breast-reconstruction
#13
Raphaëlle Billon, Romain Bosc, Yazid Belkacemi, Elias Assaf, Mounia SidAhmed-Mezi, Barbara Hersant, Jean-Paul Meningaud
PURPOSE: Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend the duration of adjuvant treatment from 5 to 10 years. The association between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. However, while estrogens play a crucial role in wound healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative complications, including wound healing complications...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28657247/giant-desmoid-tumour-of-the-thorax-following-latissimus-dorsi-and-implant-breast-reconstruction-case-report-and-review-of-the-literature
#14
A M Collins, A M Granahan, D G Healy, C A Lawlor, S P O'Neill
The case of a giant thoracic desmoid tumour in a 44-year-old woman, who presented two years following a breast reconstruction with a latissimus dorsi (LD) flap and implant, is reported. Clinical findings included a rapidly growing, painless mass. Computed tomography (CT) suggested skin and intercostal soft tissue invasion. The tumour was resected en bloc with the LD muscle, implant capsule and underlying rib segments. The resultant thoracic and abdominal wall defects were reconstructed with Dualmesh® and polypropylene meshes respectively...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28654558/the-efficacy-of-ultrasound-guided-type-ii-pectoral-nerve-blocks-in-perioperative-pain-management-for-immediate-reconstruction-after-modified-radical-mastectomy-a-prospective-randomized-study
#15
Kaiyuan Wang, Xiaobei Zhang, Tingting Zhang, Hui Yue, Shan Sun, Hongwei Zhao, Peng Zhou
OBJECTIVES: The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi (LD) flap after modified radical mastectomy. METHODS: Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (Group P, n=32) or the general anesthesia alone group (Group G, n=32)...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28628501/comparison-of-donor-site-drainage-duration-and-seroma-rate-between-latissimus-dorsi-musculocutaneous-flaps-and-thoracodorsal-artery-perforator-flaps
#16
Masaki Arikawa, Shimpei Miyamoto, Masahide Fujiki, Takuya Higashino, Azusa Oshima, Minoru Sakuraba
INTRODUCTION: Donor site seroma formation and prolonged drainage duration are common complications of using latissimus dorsi musculocutaneous (LDMC) flaps. The present retrospective study aimed to investigate the effect of types of back flap harvest on drainage duration and seroma formation rates. METHODS: Adult patients (n = 155) who underwent reconstruction with a latissimus dorsi flap from January 2010 to October 2015 were included in the study, of which 54 patients underwent breast reconstruction with a pedicled LDMC flap (LD breast group), 80 patients underwent an LDMC flap transfer for purposes other than breast reconstruction (LD nonbreast group), and 21 patients underwent soft tissue reconstruction with a thoracodorsal artery perforator (TAP) flap (TAP group)...
August 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28621194/-breast-reconstruction-surgery-with-endoscopic-assisted-latissimus-dorsi-muscle-flap
#17
Gábor Bognár, András Novák, György Ledniczky, Gábor István
The results obtaining with breast reconstruction surgery are not always satisfactory for the patients. Reconstruction with pure latissimus dorsi flap is useful option and due to endoscopic harvest large scar on the back can be avoided. The skin sparing mastectomy and even the sentinel lymph node biopsy or lymphadenectomy can be performed using a single incision in the axilla. Also the immediate reconstruction with endoscopically assisted harvest of the latissimus dorsi muscle flap in selective cases can be done using the same incision...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28560022/combined-tram-flap-with-latissimus-dorsi-myocutaneous-flap-for-reconstruction-of-a-large-breast-post-radiation-induced-necrosis
#18
Ahmed Al Maksoud, Mohammed Moneer, Adel K Barsoum
Radiation therapy is a critical component of breast cancer management following breast-conserving surgery. Post-radiation sequelae are greater in women with larger breasts, given the need for higher doses and dosing heterogeneity. The goal of breast reconstruction post-mastectomy is to improve the quality of life and add no more health risk. The optimal reconstruction should make the patient feel as natural as possible. Reconstruction of a large-sized breast with aesthetically satisfactory outcome poses a challenge to the breast surgeon...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#19
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28525414/the-muscle-sparing-latissimus-dorsi-flap-for-breast-reconstruction-a-retrospective-review-of-126-consecutive-flaps
#20
Jonathan Cook, Jessica Waughtel, Christopher Brooks, Dawn Hardin, Yin Kan Hwee, Yoav Barnavon
Our experience in the use of muscle-sparing latissimus dorsi (MSLD) flaps for breast reconstruction is presented. The procedure was performed on 83 patients by the senior author over an 8-year period. Of the 83 patients reviewed, a total of 126 MSLD flaps were done for immediate (26) or delayed (100) breast reconstructions. Preoperative and postoperative photographs were taken of all patients, and complications as well as ancillary procedures were recorded. The MSLD flap is shown to be a versatile option for breast reconstruction in a variety of clinical settings, with minimal complications and satisfactory aesthetic results...
June 2017: Annals of Plastic Surgery
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