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https://www.readbyqxmd.com/read/29325422/outcomes-in-deep-inferior-epigastric-perforator-flap-and-implant-based-reconstruction-does-age-really-matter
#1
Lauren V Kuykendall, Angie Zhang, Bugra Tugertimur, Sara Bijan, Corin Agoris, Ambuj Kumar, Deniz Dayicioglu
Despite the growing elderly population, there is limited research specific to this demographic concerning breast reconstruction (BR). Lack of evidence-based BR recommendations in older populations may contribute to misconceptions and subsequent underutilization of BR, especially autologous BR. Patients who received either deep inferior epigastric perforator (DIEP) flap BR or tissue expander/implant (TE/I) BR by a single surgeon between July 2011 and July 2015 were surveyed postoperatively by using the psychometrically validated BREAST-Q questionnaire to determine patient satisfaction...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/29324933/brachytherapy-in-soft-tissue-tumours-an-interdisciplinary-challenge
#2
Silvanie Volz, Konstantinos Kalousis, Jung In Song, Tobias Kisch, Eike Wenzel, Peter Mailänder
OBJECTIVE: Interdisciplinary work including surgery and additive radiotherapy is often needed for the therapy of tumours. Beneath this, brachytherapy is an important part of the radiotherapy. It was first used over 100 years ago and is in regular use after the development of afterload technology in the early 1970s. Today it is often used in different tumour therapies, for example in soft tissue sarcoma or breast tumours, in order to decrease the risk of local recurrence. Concerning its benefits, higher doses could be used because of the localized effect with equivalent local control rate and less toxicity of treatment...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29315799/preserving-a-patent-diep-pedicle-to-facilitate-salvage-breast-reconstruction-with-a-second-free-flap-a-case-report
#3
Dimitris Reissis, Daniel P Butler, Francis P Henry, Simon H Wood
Surgeons performing free flap breast reconstruction need to have a range of techniques in their armamentarium to successfully salvage cases of flap failure. We present a case of 47-year-old patient who suffered near-total right breast deep inferior epigastric perforator (DIEP) flap failure 3 days post-bilateral immediate breast reconstruction with DIEP flaps. At debridement, the DIEP pedicle was noted to be patent with preserved perfusion to a small segment of tissue around the origin of the pedicle. This tissue and the DIEP pedicle itself were therefore preserved to facilitate subsequent breast reconstruction using stacked transverse upper gracilis flaps anastomosed end-to-end to the original DIEP pedicle...
January 8, 2018: Microsurgery
https://www.readbyqxmd.com/read/29309508/percutaneous-purse-string-suture-an-innovative-percutaneous-technique-for-inframammary-fold-creation-and-improved-breast-projection-in-reconstructive-surgery
#4
Moustapha Hamdi, Alexander Anzarut, Benoit Hendrickx, Socorro Ortiz, Assaf Zeltzer, Elisabeth A Kappos
Background: Lipofilling for breast reconstruction has become increasingly common. Creation of a well-defined inframammary fold (IMF) is integral to achieving symmetrical aesthetic results. This has traditionally been done under direct vision through an open incision. Objectives: The authors present their experience in reconstructive breast surgery with a novel percutaneous technique for IMF creation and improvement of projection without the need for large incisions...
December 22, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29309333/flap-mastopexy-in-autologous-breast-reconstruction-timing-and-technique
#5
Jared Troy, Andrea Little, Lauren Kuykendall, Deniz Dayicioglu
BACKGROUND: Techniques in breast reconstruction have significantly advanced the possibility to create more natural and aesthetically appealing breasts. Despite thorough preoperative planning and vigilant operative technique, symmetry remains a concern for select patients who have undergone autologous breast reconstruction. Although symmetry procedures of the contralateral breast have been well described in the literature, little has been published regarding secondary revision in the autologous reconstructed breast, leaving uncertainty as to the appropriate timing and technique for revision procedures that will not hinder the viability of the flap...
January 5, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29303067/modified-tumescent-solution-for-creating-working-space-during-endoscopic-thyroidectomy
#6
Li-Yong Zhang, Wen-Xin Zhao, Bo Wang, Shou-Yi Yan, Jia Wen
OBJECTIVE: To study the feasibility of gas-liquid mixing tumescent solution for creating a working space (WS) in endoscopic thyroidectomy (ET). MATERIALS AND METHODS: A prospective study was performed on 186 patients with thyroid tumor who had undergone ET via chest and breast approach. Patients were randomly divided into 2 groups to receive traditional tumescent solution as group A and modified tumescent solution (gas-liquid mixing tumescent solution) as group B...
January 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29302729/color-change-after-paramedical-pigmentation-of-the-nipple-areola-complex
#7
Shoichi Tomita, Katsuya Mori, Takeshi Miyawaki
BACKGROUND: Reconstruction of the nipple-areola complex is the final process in breast reconstruction. Local flaps and paramedical pigmentation is one of the major procedures for this. However, fading after paramedical pigmentation leads to a color difference between the selected pigment and its color in the skin. The aim of this study is to make a proposition in color choice of paramedical pigmentation for nipple-areola complex. METHODS: Our research focused on investigating the color changes over time after unilateral nipple-areola complex reconstruction using paramedical pigmentation in 25 patients to propose suitable color selections...
January 4, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29302498/erratum-to-propeller-thoracodorsal-artery-perforator-flap-for-breast-reconstruction
#8
Claudio Angrigiani, Alberto Rancati, Ezequiel Escudero, Guillermo Artero, Gustavo Gercovich, Ernesto Gil Deza
[This corrects the article on p. 174 in vol. 3, PMID: 25207210.].
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302492/breast-reconstruction-of-an-unusual-configuration-using-two-paranemic-implants
#9
Naohiro Ishii, Jiro Ando, Michiko Harao, Masaru Takemae
Implant-based breast reconstruction can be performed using a choice of various types of breast implants. However, cases where the breast shapes are unsuitable for implant-based reconstruction method are occasionally encountered. We present two patients with wide trunks who underwent breast reconstruction using an unusual configuration that involved a latissimus dorsi myocutaneous flap combined with two paranemic implants.
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302489/enhancing-breast-projection-in-autologous-reconstruction-using-the-st-andrew-s-coning-technique-and-3d-volumetric-analysis
#10
Michael P Chae, Warren Matthew Rozen, Nakul Gamanlal Patel, David J Hunter-Smith, Venkat Ramakrishnan
Background: An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302477/concordance-between-preoperative-computed-tomography-angiographic-mapping-and-intraoperative-perforator-selection-for-deep-inferior-epigastric-artery-perforator-flap-breast-reconstructions
#11
Vivian B Boer, Jan J van Wingerden, Carolien F Wever, Joost J Kardux, Michiel R Beets, Hester J van der Zaag-Loonen, Willem J Theuvenet
Background: Preoperative imaging for perforator identification prior to a deep inferior epigastric artery perforator (DIEP) flap elevation for breast reconstruction has many advantages. Currently, computed tomography (CT) angiography provides good visualization of the perforators and their course, and is thus the imaging technique of choice. The primary aim of this study was to determine the concordance between the perforators identified preoperatively and the perforators ultimately selected intraoperatively, with a standardized protocol, in a single institution...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29302307/breast-fibromatosis-an-unusual-breast-disease
#12
Khaled Abdelwahab, Omar Hamdy, Mona Zaky, Nirmeen Megahed, Saleh Elbalka, Mohamed Elmetwally, Adel Denewer
Fibromatosis is a benign tumor that rarely affects the breast and is an unusual site for its occurrence. Whilst the definite etiology of breast fibromatosis is unclear, it may present itself following surgical trauma or silicone implant. Wide local excision with adequate safety margins is considered the standard of care. We review three cases of breast fibromatosis who were presented to and operated in the Oncology center, Mansoura universty (between April 2014 and August 2016). Two of these cases underwent wide local excision and primary closure of the defect whilst the other one was reshaped by mini latismuss dorsi flap...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29289500/perforator-mapping-reduces-the-operative-time-of-diep-flap-breast-reconstruction-a-systematic-review-and-meta-analysis-of-preoperative-ultrasound-computed-tomography-and-magnetic-resonance-angiography
#13
REVIEW
Ryckie G Wade, James Watford, Justin C R Wormald, Russell J Bramhall, Andrea Figus
BACKGROUND: Prior to DIEP flap breast reconstruction, mapping the perforators of the lower abdominal wall using ultrasound, computed tomography angiography (CTA) or magnetic resonance angiography (MRA) reduces the risk of flap failure. This review aimed to investigate the additional potential benefit of a reduction in operating time. METHODS: We systematically searched the literature for studies concerning adult women undergoing DIEP flap breast reconstruction, which directly compared the operating times and adverse outcomes for those with and without preoperative perforator mapping by ultrasound, CTA or MRA...
December 12, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29285789/intraoperative-objective-evaluation-of-venous-congestion-in-deep-epigastric-artery-perforator-flap-breast-reconstruction-a-pilot-study
#14
Shinsuke Akita, Yoshihisa Yamaji, Hideki Tokumoto, Yoshitaro Sasahara, Takafumi Tezuka, Yoshitaka Kubota, Motone Kuriyama, Nobuyuki Mitsukawa
BACKGROUND: In a deep epigastric artery perforator (DIEP) flap breast reconstruction, the necessity of additional anastomosis of the superficial inferior epigastric vein (SIEV) should be determined intraoperatively. The purpose of this pilot study is to propose a method to detect venous congestion intraoperatively using the blood glucose measurement index (BGMI). METHODS: In 70 DIEP flaps of 67 patients for breast reconstruction, the ratio of blood glucose content in the flap to systemic blood glucose (BGMI) was measured immediately after wound closure...
December 29, 2017: Microsurgery
https://www.readbyqxmd.com/read/29285380/assessment-of-the-use-of-latissimus-dorsi-restoration-during-modified-radical-mastectomy-in-breast-cancer-patients
#15
Chao Yang, Xinle Wang, Geng Zhang, Liu Yang, Xuan Guo, Xue Wang, Zhenchuan Song
The incision area of modified radical mastectomy in breast cancer patients is associated with subcutaneous effusion and skin flap necrosis as the most common complications. The aim of the present study was to assess the effect of latissimus dorsi restoration during modified radical mastectomy in breast cancer patients by evaluating 365 cases. Among these cases, 185 received modified radical mastectomy combined with intraoperative latissimus dorsi restoration, while 180 received modified radical mastectomy alone...
December 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29280859/outcome-analysis-of-free-flap-salvage-in-outpatients-presenting-with-microvascular-compromise
#16
Rene D Largo, Jesse C Selber, Patrick B Garvey, Edward I Chang, Matthew M Hanasono, Peirong Yu, Charles E Butler, Donald P Baumann
BACKGROUND: Extensive flap salvage attempts are routinely performed in patients with late-onset flap vascular crisis despite low flap survival rates. A knowledge gap exists in management of compromised free flaps in patients who present with perfusion-related complications after hospital discharge. METHODS: A retrospective review of 7443 free flaps used in 7128 cancer patients at a single institution from January of 2001 to March of 2015 was performed. RESULTS: Of 7443 free flap reconstructions, 856 patients (12 percent) were taken back to the operating room...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29245318/recurrent-malignant-phyllodes-tumor-of-the-breast-a-case-report
#17
Qinqin Wang, Jing Su, Yutao Lei
RATIONALE: Phyllodes tumor is a rare fibro epithelial neoplasm of the breast. They resemble fibroadenomas clinically and can be mistakenly ignored sometimes. PATIENT CONCERNS: We report the case of a young woman with her first presentation to hospital due to a hypoglycemia and she underwent 2 excised fibroadenomas in the same breast before diagnosed of malignant phyllodes tumor. She was complaining about 2 masses presented in her right breast 4 months after mastectomy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240640/indocyanine-green-angiography-use-in-breast-reconstruction-a-national-analysis-of-outcomes-and-cost-in-110-320-patients
#18
Anmol Chattha, Alexandra Bucknor, Austin D Chen, Bernard T Lee, Samuel J Lin
BACKGROUND: Indocyanine Green (ICG) angiography has gained popularity in breast reconstruction due to its ability to assess the viability of both mastectomy skin and tissue flaps. We aim to analyze trends and outcomes associated with the use of ICG angiography in breast reconstruction. METHODS: Using 2012-2014 data from the Healthcare Cost and Utilization Project National Inpatient Sample, Agency for Healthcare Research and Quality, we identified breast reconstructions that were performed with or without the use of ICG angiography...
December 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29239797/autologous-breast-reconstruction-using-the-immediately-lipofilled-extended-latissimus-dorsi-flap
#19
N Johns, N Fairbairn, M Trail, A Ewing, L Yong, C Raine, J M Dixon
BACKGROUND: The latissimus dorsi flap is a popular choice for autologous breast reconstruction. To dramatically improve volume, we report our experience of using the immediately lipofilled extended latissimus dorsi (ELD) flap and show it as a valid option for autologous breast reconstruction. METHODS: Patients undergoing the procedure between December 2013 and June 2016 were included. Demographic, clinical and operative factors were analysed, together with in-hospital morbidity and duration of postoperative hospital stay...
November 24, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29227815/meta-analysis-of-flap-perfusion-and-donor-site-complications-for-breast-reconstruction-using-pedicled-versus-free-tram-and-diep-flaps
#20
REVIEW
Woonhyeok Jeong, Seongwon Lee, Junhyung Kim
OBJECTIVES: The transverse rectus abdominis musculocutaneous (TRAM) flap is an important option for breast reconstruction. Several studies have recently evaluated whether a greater number of complications result from the use of pedicled TRAM (pTRAM) flaps versus either free TRAM (fTRAM) flaps or deep inferior epigastric artery perforator (DIEP) flaps. To clarify the evidence regarding this issue, we performed an objective meta-analysis of published studies. MATERIALS AND METHODS: A literature search of articles published between January 1, 1990, to January 1, 2017 was performed using the PubMed, EMBASE, Scopus, and Cochrane databases...
December 8, 2017: Breast: Official Journal of the European Society of Mastology
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