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Latissimus dorsi flap breast reconstruction

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https://www.readbyqxmd.com/read/29135896/vertical-skin-paddle-orientation-for-the-latissimus-dorsi-flap-in-breast-reconstruction-a-modification-to-simultaneously-correct-inferior-pole-constriction-and-improve-projection
#1
Megan Fracol, Michelle Grim, Steven Lanier, Neil A Fine
The latissimus dorsi myocutaneous flap (LDMF) is a reliable and frequently used option to bring vascularized skin and soft tissue to improve the stability and aesthetic result in breast reconstruction. Standard techniques with skin paddle inset in a horizontal or oblique fashion preferentially improve anterior projection (when inset at the mastectomy scar) or lower pole and infra-mammary fold (IMF) constriction (when inset into the IMF). Here, we describe a modification for inset of the LDMF that improves both anterior projection and lower pole/IMF constriction, while also allowing the latissimus muscle to fan out and provide complete implant coverage...
November 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29080662/indications-and-controversies-for%C3%A2-complete-and-implant-enhanced-latissimus-dorsi-breast-reconstructions
#2
REVIEW
Oren P Mushin, Paige L Myers, Howard N Langstein
This article describes the use of implant-enhanced and total-autologous latissimus dorsi myocutaneous flaps in breast reconstruction. It addresses the indications for use of this reconstruction alternative, which have recently been expanded thanks to the advent of high-volume fat grafting. Given its straightforward dissection, reliable vascular pedicle, variety of approaches, and potential for excellent aesthetic results, use of latissimus dorsi flaps may be considered among first-line options in selected patients...
January 2018: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/29076313/selection-of-oncoplastic-surgery-in-asian-breast-cancer-patients
#3
Eui Sun Shin, Hyo In Kim, Seung Yong Song, Dae Hyun Lew, Dong Won Lee
Background: Oncoplastic surgery is increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small- to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors determining the optimal surgical method should be considered. Methods: A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD) flap transposition, and reduction oncoplasty to restore the breast volume and symmetry...
October 27, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29064918/updated-evidence-on-the-oncoplastic-approach-to-breast-conservation-therapy
#4
Albert Losken, Alexandra M Hart, Abhishek Chatterjee
The oncoplastic approach to breast conservation therapy has become a useful and popular option for women with breast cancer who wish to preserve their breast. The initial driving forces were aimed at minimizing the potential for a breast conservation therapy deformity; however, various other benefits have been identified that include broadening the indications for breast conservation therapy in some patients and improved margin control. The various techniques can be categorized into glandular rearrangement techniques such as breast reductions usually in patients with larger breasts or flap reconstruction such as the latissimus dorsi muscle usually in patients with smaller breasts...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29058926/-breast-angiosarcoma-induced-by-radiotherapy-surgical-treatment-options-and-review-of-literature
#5
O Kubala, J Prokop, L Petráš, P Ihnát, P Jelínek, P Ostruszka
INTRODUCTION: Radiation-induced angiosarcoma is a rare but very aggressive tumour. The highest risk of sarcoma development is in patients after breast-conserving surgery.Case 1: The 66 years old patient underwent radical mastectomy with axillary dissection because of ductal carcinoma with consequent radiotherapy, chemotherapy and hormonal therapy. After 6 years, high-grade angiosarcoma was diagnosed and resected with negative resection margins. Within subsequent 24 months, additional three radical re-excisions were performed because of repeated sarcoma recurrence...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29039118/a-systematic-review-of-flap-fixation-techniques-in-reducing-seroma-formation-and-its-sequelae-after-mastectomy
#6
REVIEW
J van Bastelaar, L van Roozendaal, R Granzier, G Beets, Y Vissers
BACKGROUND: Seroma formation is a common complication after mastectomy. This review aims to elucidate which surgical techniques are most effective in reducing the dead space and therefore seroma formation in patients undergoing mastectomy. METHODS: A literature search was performed to identify clinical studies comparing any form of flap fixation to conventional closure technique in patients undergoing mastectomy with or without axillary clearance. Studies were eligible for inclusion if outcome was described in terms of seroma formation and/or complications of seroma formation...
October 16, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28936374/helical-tomotherapy-for-postmastectomy-radiotherapy-after-immediate-left-breast-reconstruction-a-case-study
#7
Dominique Mathieu, Nazanin Shahvary, Nicolas Côté, Kerianne Boulva, Léamarie Meloche-Dumas, Toni Vu, Erica Patocskai, Christina Bernier, David Roberge, Israel Fortin
A 43-year-old premenopausal female presented with a multicentric infiltrating lobular carcinoma of the left breast with axillary nodes metastasis. She underwent modified radical mastectomy with axillary lymph node dissection (level I and II) followed by a mixed autologous latissimus dorsi flap reconstruction with the addition of prosthesis. The final pathological analysis revealed a 6 cm invasive lobular carcinoma pT3N2aM0, grade III/III, estrogen and progesterone positive, human epidermal growth factor receptor 2 (HER2) negative, with 5/16 positive lymph nodes...
July 12, 2017: Curēus
https://www.readbyqxmd.com/read/28932726/comparison-of-morbidity-related-seroma-formation-following-conventional-latissimus-dorsi-flap-versus-muscle-sparing-latissimus-dorsi-flap-breast-reconstruction
#8
Yoshihiro Sowa, Toshiaki Numajiri, Katsuhiko Nakatsukasa, Koichi Sakaguchi, Tetsuya Taguchi
PURPOSE: The pedicled, descending-branch muscle-sparing latissimus dorsi (MSLD) flap has been widely used for breast reconstruction following total mastectomy. However, the superiority of the MSLD flap compared to the conventional latissimus dorsi (CLD) flap in preventing seroma formation has not been demonstrated. This study compares the morbidities related to seroma formation following pedicled MSLD flap and CLD flap breast reconstruction. METHODS: A total of 15 women who underwent partial mastectomy and immediate partial breast reconstruction with MSLD flaps were compared with 15 women under identical conditions with CLD flap breast reconstruction...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28918997/tolerance-of-latissimus-dorsi-in-immediate-breast-reconstruction-without-implant-to-radiotherapy
#9
G Berthet, C Faure, M A Dammacco, C Vermesch, E Delay, C Ho Quoc, N Carrabin
INTRODUCTION: Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported by patients who underwent IBR by LDF with or without subsequent radiotherapy. MATERIALS AND METHODS: We performed a retrospective case-control study in a population of women who were diagnosed with breast cancer between January 1999 and January 2014 and who had mastectomies with IBR by LDF without prostheses...
August 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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