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https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#1
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/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#2
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#3
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
November 3, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28044960/transversus-abdominis-muscle-release-tar-for-large-incisional-hernia-repair
#4
Valentin Oprea, Victor Gheorghe Radu, Doru Moga
: Background: complex ventral hernia repair is a frequent and challenging topic. Reconstructive techniques are numerous but most of them are unable to achieve the goals of hernioplasty. Posterior component separation with transverses abdominis muscle release (TAR) is a novel approach that offers a solution for complex ventral hernias. METHOD: The posterior rectus sheath is incised and the retrorectus plane is developed. In a modification of the Rives-Stoppa technique, the transversus abdominis is released medial to the linea semilunaris to expose a broad plane that extends from the central tendon of the diaphragm superiorly, to the space of Retzius inferiorly, and laterally to the retro-peritoneum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28035905/a-rare-case-of-umbilical-metastasis-after-delayed-transverse-rectus-abdominis-myocutaneous-flap-reconstruction-for-invasive-breast-cancer
#5
Nicky Claire Seymour, Rathi Rathinaezhil
A 46-year-old female presented with an inflamed and painful umbilicus. Past medical history included breast cancer, followed by metastatic sternal cancer two years after the initial breast cancer diagnosis.The painful umbilicus was confirmed metastasis from a primary breast cancer she had treated eleven years previously.Metastases to the umbilicus are rare, and are usually gastrointestinal in origin. To our knowledge this is the first report of a metastasis from any primary cancer to the umbilicus after transverse rectus abdominis myocutaneous flap (TRAM)...
December 29, 2016: Breast Disease
https://www.readbyqxmd.com/read/28032178/comparison-of-aesthetic-outcomes-between-vertical-and-horizontal-flap-insets-in-breast-reconstruction-with-the-tram-or-diep-flaps
#6
Woo Shik Jeong, Wooyeon Han, Jin Sup Eom
BACKGROUND: Tissue transfer, such as use of the transverse rectus abdominis myocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) free flaps, is considered a standard method. However, outcomes may vary among inset methods. Here we compared the aesthetic outcomes of breast reconstructions using vertical and horizontal flap inset methods. METHODS: We, respectively, reviewed 274 patients who underwent unilateral post-mastectomy breast reconstruction using TRAM or DIEP free flaps between April 2006 and December 2013...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28007030/ultrasound-anatomy-of-the-transversus-abdominis-plane-region-in-pregnant-women-before-and-after-cesarean-delivery
#7
Nicholas Kiefer, Stefanie Krahe, Ulrich Gembruch, Stefan Weber
BACKGROUND: After cesarean delivery, analgesia is often incomplete and a multimodal approach to analgesia is necessary. Transverse abdominal plane (TAP) block has been advocated in this setting, yet no systematic description of the ultrasound anatomy in pregnant women exists in the literature. Therefore, we aimed to describe the sonographical features of relevant structures in pregnant women before and after elective cesarean. METHODS: Sixty women at, or close to term scheduled for elective cesarean delivery underwent a standardized ultrasound examination before and after delivery...
December 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27996199/chronic-postsurgical-pain-outcomes-in-breast-reconstruction-patients-receiving-perioperative-transversus-abdominis-plane-catheters-at-the-donor-site-a-prospective-cohort-follow-up-study
#8
Justin Oh, Gabrielle M Pagé, Toni Zhong, Stuart McCluskey, Coimbatore Srinivas, Anne C O'Neill, James Kahn, Joel Katz, Stefan O P Hofer, Hance Clarke
BACKGROUND: Chronic postsurgical pain (CPSP) is a debilitating and costly condition. Risk factors for CPSP after autologous breast reconstruction have not been clearly established. Previously, we demonstrated that transversus abdominis plane (TAP) catheters delivering intermittent local anesthetic reduced postoperative morphine consumption. This prospective follow-up study aims to (1) compare the incidence of CPSP after autologous breast reconstruction between patients who received postoperative intermittent TAP catheters with bupivacaine or saline boluses and (2) assess the factors that contribute to the development and maintenance of CPSP in this study cohort...
December 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27943522/no-benefit-of-ultrasound-guided-transversus-abdominis-plane-tap-blocks-over-local-anaesthetic-wound-infiltration-in-elective-laparoscopic-colonic-surgery-results-of-a-double-blind-randomised-controlled-trial
#9
A Rashid, K J Gorissen, F Ris, M P Gosselink, J R Shorthouse, A D Smith, J J Pandit, I Lindsey, N Crabtree
AIM: Advances in laparoscopic techniques combined with enhanced recovery pathways have led to faster recuperation and discharge after colorectal surgery. Peripheral nerve blockade using Transversus Abdominis Plane (TAP) blocks reduce opioid requirements and provide better analgesia than inactive controls for laparoscopic colectomies. This double-blind randomized study was performed comparing TAP blocks using Bupivacaine to standardised wound infiltration with local anaesthetic (LA). METHODS: 71 Patients were randomised between either TAP-block or wound infiltration...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27942133/effect-of-spinal-decompression-on-the-lumbar-muscle-activity-and-disk-height-in-patients-with-herniated-intervertebral-disk
#10
Jeong-Il Kang, Dae-Keun Jeong, Hyun Choi
[Purpose] This study was conducted to clarify the difference in therapeutic effects between traction and decompression therapies, and their clinical therapeutic significance. [Subjects and Methods] The subjects were 31 patients aged 35 to 50 years who had unilateral or bilateral lumbar and radicular leg pain. An intervention program was implemented in 31 patients with lumbar herniated intervertebral disks. For the experimental group, 15 subjects were randomly selected to receive decompression therapy and trunk stabilization exercise...
November 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27913969/laser-photobiomodulation-830-and-660%C3%A2-nm-in-mast-cells-vegf-fgf-and-cd34-of-the-musculocutaneous-flap-in-rats-submitted-to-nicotine
#11
Lais Mara Siqueira das Neves, Gabriella de Paula Marcondes Ferreira Leite, Alexandre Marcio Marcolino, Carlos Eduardo Pinfildi, Sérgio Britto Garcia, João Eduardo de Araújo, Elaine Caldeira de Oliveira Guirro
The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm...
December 2, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27906762/complications-in-postmastectomy-breast-reconstruction-one-year-outcomes-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#12
Edwin G Wilkins, Jennifer B Hamill, Hyungjin M Kim, John Y Kim, Richard J Greco, Ji Qi, Andrea L Pusic
OBJECTIVE: In postmastectomy reconstruction, procedure choice is heavily influenced by the relative risks of the various options. This study sought to evaluate complications in a large, multicenter patient population. SUMMARY OF BACKGROUND DATA: Previous studies have reported widely varying complication rates, but have been limited by their single center designs and inadequate controlling for confounders in their analyses. METHODS: Eleven sites enrolled women undergoing first time, immediate, or delayed reconstruction following mastectomy for cancer treatment or prophylaxis...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27897414/a-comparative-study-of-software-programmes-for-cross-sectional-skeletal-muscle-and-adipose-tissue-measurements-on-abdominal-computed-tomography-scans-of-rectal-cancer-patients
#13
Jeroen L A van Vugt, Stef Levolger, Arvind Gharbharan, Marcel Koek, Wiro J Niessen, Jacobus W A Burger, Sten P Willemsen, Ron W F de Bruin, Jan N M IJzermans
BACKGROUND: The association between body composition (e.g. sarcopenia or visceral obesity) and treatment outcomes, such as survival, using single-slice computed tomography (CT)-based measurements has recently been studied in various patient groups. These studies have been conducted with different software programmes, each with their specific characteristics, of which the inter-observer, intra-observer, and inter-software correlation are unknown. Therefore, a comparative study was performed...
November 22, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#14
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27821975/the-effect-of-lumbar-pelvic-alignment-and-abdominal-muscle-thickness-on-primary-dysmenorrhea
#15
Moon-Jeong Kim, Il-Hun Baek, Bong-Oh Goo
[Purpose] The purpose of this study was to identify effects of malalignment of the lumbar pelvis, as a passive element, and the thicknesses of abdominal muscles, as active elements, on primary dysmenorrhea. [Subjects and Methods] The subjects were divided into a primary dysmenorrhea group and normal group according to Visual Analogue Scale, and ultimately there were 28 subjects in the dysmenorrhea group and 22 subjects in the normal group. Alignment of the lumbar pelvis was measured by using a Formetric 4D analysis system, and the thicknesses of abdominal muscles were measured by using ultrasound imaging...
October 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/27798424/considering-the-optimal-timing-of-breast-reconstruction-with-abdominal-flaps-with-adjuvant-irradiation-in-370-consecutive-pedicled-transverse-rectus-abdominis-myocutaneous-flap-and-free-deep-inferior-epigastric-perforator-flap-performed-in-a-chinese-oncology
#16
Shanshan He, Jian Yin, Geoffrey L Robb, Jingyan Sun, Xuehui Zhang, Haixin Li, Jing Liu, Chunyong Han
PURPOSE: There is an ongoing debate on the optimal sequence of radiation and breast reconstruction. The purpose of this article was to (a) assess the impact of radiation on autologous breast reconstruction and (b) analyze the best timing for autologous breast reconstruction in the setting of radiation in a Chinese population. METHODS: A retrospective review of patients undergoing breast reconstruction with autologous lower abdominal flaps between 2001 and 2014 in the Tianjin Medical University and Cancer Hospital was performed...
October 28, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27757337/abdominal-closure-after-tram-flap-breast-reconstruction-with-transversus-abdominis-muscle-release-and-mesh
#17
Antonio Espinosa-de-Los-Monteros, Héctor Avendano-Peza, Yuri W Novitsky
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction...
September 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27743083/free-versus-pedicled-tram-flaps-cost-utilization-and-complications
#18
Samuel Golpanian, David J Gerth, Jun Tashiro, Seth R Thaller
INTRODUCTION: Conventionally, free transverse rectus abdominis myocutaneous (fTRAM) flap breast reconstruction has been associated with decreased donor site morbidity and improved flap inset. However, clinical success depends upon more sophisticated technical expertise and facilities. This study aims to characterize postoperative outcomes undergoing free versus pedicled TRAM (pTRAM) flap breast reconstruction. METHODS: Nationwide inpatient sample database (2008-2011) was reviewed for cases of fTRAM (ICD-9-CM 85...
December 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27707079/the-protective-effect-of-cilostazol-on-transverse-rectus-abdominis-myocutaneous-flap-in-rats
#19
Ayfer Özdemir, Erkan Orhan, Serdar Altun, Emre İnözü
OBJECTIVE: Transverse Rectus Abdominis Myocutaneous (TRAM) flap is commonly used in breast reconstruction. The aim of this study is to demonstrate the effects of cilostazol on TRAM flap viability in a rat TRAM model. METHODS: Twenty-four Wistar rats were used. They were divided into four groups. Rats in Group 1 were applied TRAM flap. In Group 2, cilostazol 30 mg/kg was administered to rats via oral gavage 3 hours before the flap surgery. After the flap surgery, cilostazol 30 mg/kg was administered via oral gavage twice a day for 7 days...
October 6, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27704608/direct-thrombectomy-as-a-salvage-technique-in-free-flap-breast-reconstruction
#20
Ki Yong Hong, Lan Sook Chang, Hak Chang, Kyung Won Minn, Ung Sik Jin
BACKGROUND: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. METHODS: A total of 488 patients who underwent breast reconstruction using a free transverse rectus abdominis myocutaneous flap between March 2009 and February 2014 were retrospectively analyzed...
October 5, 2016: Microsurgery
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