Mohamed Tawfeek Younis Ali
Professor
Usefulness of nerve.sparing pedicled segmental latissimus dorsi muscle flap combined with lateral thoracic skin flap for partial volume reconstruction in laterally located breast cancer�����
• 2023
Publication Information
Authors
Ayman M. Abdelmofeed1 � Mohammed A. Fadey2 � Ola Seif1 � Mohamed H. Abdelhalim1 � Mohamed T. Younes1D.**
Keywords
Latissimus dorsi muscle flap � Pedicled island flap � Conservative mastectomy
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publication.type
Local
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Abstract
Background The latissimus dorsi muscle (LDM) is a flexible muscle that is frequently employed in various reconstructive
operations. Breast-conserving surgery is widely acknowledged as an effective treatment for breast cancer, and the latissimus
dorsi muscle flap is a straightforward, dependable technique for partial breast reconstruction.
Methods A pedicled segmental latissimus dorsi muscle flap was employed in 20 patients with laterally situated breast cancer
treated at our institution from January 2018 to December 2021. During a 6-month postoperative follow-up period, patients
were polled on their overall satisfaction and cosmetic satisfaction. Plastic surgeons assessed the aesthetic and functional
outcomes in terms of breast shape and symmetry, as well as muscular function.
Results The mean operative time was 120 � 35.2 min while the mean postoperative hospital stay was 2.5 days (range,
1.5�3 days). There were no donor site complications such as intraoperative bleeding, postoperative hematoma, or infection,
and postoperative drain removal was done on average after 5 days. The average weight of specimens was 50�160 gm
with a mean of 100 gm, and the locations of the masses were the upper lateral quadrant (n = 15), the lower lateral quadrant
(n = 2), and the central lateral area (n = 3). Complications developed in 6 of the cases, hematoma in 2 cases, wound seroma
developed in the donor site in 2 cases, and weakness in shoulder movement in 2 cases, and the majority of the patients were
satisfied with their cosmetic outcomes. No tumor recurrence was reported.
Conclusion Replacement of 20 to 40% of breast volume in the upper and the lower outer quadrants with a latissimus
dorsi muscle flap as nerve-sparing pedicled segmental flap that can be harvested from the same axillary incision of lymphadenectomy
is a good alternative reconstruction technique after partial mastectomy. This resulted in an acceptable
postoperative scar, less pain, and early upper extremity movement, so this technique is considered a useful and reliable
technique in correcting breast deformity after breast-conserving surgery, especially in laterally located breast cancer.
Level of evidence: Level IV, therapeutic study.#�x
operations. Breast-conserving surgery is widely acknowledged as an effective treatment for breast cancer, and the latissimus
dorsi muscle flap is a straightforward, dependable technique for partial breast reconstruction.
Methods A pedicled segmental latissimus dorsi muscle flap was employed in 20 patients with laterally situated breast cancer
treated at our institution from January 2018 to December 2021. During a 6-month postoperative follow-up period, patients
were polled on their overall satisfaction and cosmetic satisfaction. Plastic surgeons assessed the aesthetic and functional
outcomes in terms of breast shape and symmetry, as well as muscular function.
Results The mean operative time was 120 � 35.2 min while the mean postoperative hospital stay was 2.5 days (range,
1.5�3 days). There were no donor site complications such as intraoperative bleeding, postoperative hematoma, or infection,
and postoperative drain removal was done on average after 5 days. The average weight of specimens was 50�160 gm
with a mean of 100 gm, and the locations of the masses were the upper lateral quadrant (n = 15), the lower lateral quadrant
(n = 2), and the central lateral area (n = 3). Complications developed in 6 of the cases, hematoma in 2 cases, wound seroma
developed in the donor site in 2 cases, and weakness in shoulder movement in 2 cases, and the majority of the patients were
satisfied with their cosmetic outcomes. No tumor recurrence was reported.
Conclusion Replacement of 20 to 40% of breast volume in the upper and the lower outer quadrants with a latissimus
dorsi muscle flap as nerve-sparing pedicled segmental flap that can be harvested from the same axillary incision of lymphadenectomy
is a good alternative reconstruction technique after partial mastectomy. This resulted in an acceptable
postoperative scar, less pain, and early upper extremity movement, so this technique is considered a useful and reliable
technique in correcting breast deformity after breast-conserving surgery, especially in laterally located breast cancer.
Level of evidence: Level IV, therapeutic study.#�x