Background Breast cancer patients with locally advanced breast cancer who require radical mastectomy are left with large chest wall defects. This poses a significant reconstructive challenge as many high-risk patients require timely postmastectomy adjuvant therapy. While the reverse abdominoplasty technique is commonly used for aesthetic improvement of the anterior trunk, it can be also be effectively used for closure of extensive mastectomy defects in this patient population. Methods We conducted a retrospective cohort study of all consecutive patients who underwent an extensive radical mastectomy followed by immediate closure with the reverse abdominoplasty technique at a single tertiary cancer center from June 2017 to July 2022. Patients who had concurrent skin grafting or breast mound flap reconstruction were excluded. Demographic, medical, oncologic, and reconstructive data were collected. Results Six patients were treated with reverse abdominoplasty for 9 chest wall defects after surgical excision of locally advanced breast cancer. The median tumor size was 10.7 cm (range, 6.7–10 cm) and the median mastectomy weight was 865.7 g (range, 356.4–1247.7 g). On average, the operation length was 191 minutes (range, 86–257 minutes) and the postoperative length of stay was 2.2 days (range, 1–5 days). All patients underwent systemic adjuvant therapy and the median time from surgery to initiation of therapy was 44.5 days (range, 32–75 days). Conclusions Reverse abdominoplasty is a simple and safe technique to reliably close large defects after locally advanced breast cancer excision. It has a short operative time, hospital stay, and turnaround time to initiation of adjuvant therapy.

Introduction Breast cancer–related lymphedema (BCRL) is a chronic condition that can negatively affect the quality of life of breast cancer survivors. Immediate lymphatic reconstruction (ILR) at the time of axillary lymph node dissection is emerging as a technique for the prevention of BCRL. This study compared the incidence of BRCL in patients who received ILR and those who were not amenable to ILR. Methods Patients were identified through a prospectively maintained database between 2016 and 2021. Some patients were deemed nonamenable to ILR due to a lack of visualized lymphatics or anatomic variability (eg, spatial relationships or size discrepancies). Descriptive statistics, independent t test, and Pearson χ2 test were used. Multivariable logistic regression models were created to assess the association between lymphedema and ILR. A loose age-matched subsample was created for subanalysis. Results Two hundred eighty-one patients were included in this study (252 patients who underwent ILR and 29 patients who did not). The patients had a mean age of 53 ± 12 years and body mass index of 28.6 ± 6.8 kg/m2. The incidence of developing lymphedema in patients with ILR was 4.8% compared with 24.1% in patients who underwent attempted ILR without lymphatic reconstruction (P = 0.001). Patients who did not undergo ILR had significantly higher odds of developing lymphedema compared with those who had ILR (odds ratio, 10.7 [3.2–36.3], P < 0.001; matched OR, 14.2 [2.6–77.9], P < 0.001). Conclusions Our study showed that ILR was associated with lower rates of BCRL. Further studies are needed to determine which factors place patients at highest risk of developing BCRL.

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Although laparoscopic sleeve gastrectomy (LSG) is a simple procedure, it isn’t standardized when it comes to operative technique. Staple line reinforcement (SLR) is proven to be effective in reducing adverse postoperative outcomes, most importantly leaks and bleeding. However, no enough evidence in the literature supports one SLR method over others. The most prominent SLR methods available are oversewing/suturing (OS/S), omentopexy/gastropexy (OP/GP), Seamguard buttressing (SGB), bovine pericardial strips / peri-strip dry (BPS/PSD) buttressing, and fibrin gluing (FG). This study focuses on comparing BPS/PSD buttressing with no-SLR, OS/S, and Seamguard buttressing (SGB), by compiling all the data published in comparative studies, in a single meta-analysis paper.