Breast Reconstruction in Poland Syndrome Patients with Latissimus Dorsi Myo Flap and Implant: An Efficient Endoscopic Approach Using Single Transverse Axillary Incision

Liu, Chunjun; Luan, Jie; Ouyang, Yiye; Zhuang, Yan; Xu, Boyang; Chen, Lin; Li, Shangshan; Fu, Su; Xin, Minqiang

doi:10.1007/s00266-019-01346-0

Cited by 20 publications

(37 citation statements)

References 28 publications

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“…The good result might be attributed to the prolonged periods of drainage, elastic compression of the operation areas, and immobilization of the shoulder joints. Compared with 8.0 days in a recent study applying endoscopy-assisted LDMF harvest for breast reconstruction [ 21 ], the mean drain time in our research was 10.1 days. As for the reason, the strict criteria for drain removal was considered (less than 20 ml VS 50 ml per day).…”

Section: Discussioncontrasting

confidence: 67%

“…Moreover, it is hard to control the bleeding during the medial dissection encountering the lumbar perforators, precisely where the access is most restricted. Some studies reported techniques for LDMF harvest via the mastectomy incision and axillary incision under the endoscopic guidance [ 14 , 21 ]. Although these techniques have the advantage of no scar on the back, various specific retractors and other self-designed instruments are essential for the procedure.…”

Section: Discussionmentioning

confidence: 99%

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Latissimus dorsi muscle flap transfer through endoscopic approach combined with the implant after tissue expansion for breast reconstruction of mastectomy patients

Xia

et al. 2022

BMC Surg

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Background Implant-based breast reconstruction is easy to be performed but has flaws that an unnatural appearance might be presented when no sufficient coverage existing. While autologous tissue reconstruction also has disadvantages like donor site scar and skin patch effect. There is a demand for a new method to obtain natural and aesthetic appearance while surmounting drawbacks of conventional breast reconstruction surgery. Methods A retrospective review of thirty-one patients undergoing tissue expander (TE)/implant two-stage breast reconstruction with latissimus dorsi muscle flap (LDMF) transfer through endoscopic approach in Peking University Third Hospital from April 2016 to August 2020 was performed. The LDMF harvest time, drain time, and complications were reviewed. The 3D volume was obtained to assess the volume symmetry of bilateral breasts. The BREAST-Q reconstruction module was used to evaluate the satisfaction. Results The mean endoscopic LDMF harvest time was 90.4 min. In the mean follow-up of 11.2 months, there were no severe capsular contracture happened. The reconstructed side achieved good volume symmetry to the contralateral side (P = 0.256). Based on the evaluation of the BREAST-Q scores, the outcome of Satisfaction with Breasts was excellent or good in 87.1% of the cases. Conclusions The novel type of two-stage breast reconstruction protocol, which includes tissue expansion followed by implant insertion with endoscopy-assisted LDMF transfer, could effectively reduce visible scars, avoid the patch effect, while require short time for LDMF harvest and present low incidence of complications. It is a promising method for breast reconstruction because it achieves good outcomes in the mastectomy patients.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Latissimus dorsi muscle flap transfer through endoscopic approach combined with the implant after tissue expansion for breast reconstruction of mastectomy patients

Xia

et al. 2022

BMC Surg

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“…In severe (Grade II) and very severe (Grade III) Poland deformities of female patients, the underlying musculoskeletal deformity is often not sufficiently treated with an implant alone. Combinations of pedicled myocutaneous flaps such as the LD in combination with an implant, represent a frequently used option for reconstruction in female patients with a low to normal BMI [ 46 , 47 ]. Insertion of silicone implants is seen as a safe procedure to compensate breast asymmetry in cases with none to mild chest deformity, but patients have to be informed about the possible risk and long-term implications, such as capsular contracture and the lifelong need for potential implant exchange [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI

Mahrhofer

Schoeller

Casari

et al. 2021

JCM

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Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data.

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“…Recently, however, the transaxillary endoscopic technique was introduced to perform breast reconstruction with the latissimus dorsi myocutaneous flap, which was conducive to reducing scar length and concealing scar location. 4 The robotic surgical system as a minimally invasive technique is more advanced than the endoscope. A real-time, high-definition, three-dimensional optic of the robotic approach provides a superior image and eliminates surgeons' tremors for highly accurate dissection, which has placed great expectations for improvement on intraoperative bleeding, donor-site scar, hospital stay, patient satisfaction, and postoperative complications.…”

Section: Ementioning

confidence: 99%

Breast Reconstruction Using a Three-Dimensional Absorbable Mesh Scaffold and Autologous Fat Grafting: A Composite Strategy Based on Tissue-Engineering Principles

Hwang

Wu²

2021

Plastic &Amp; Reconstructive Surgery

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Breast Reconstruction in Poland Syndrome Patients with Latissimus Dorsi Myo Flap and Implant: An Efficient Endoscopic Approach Using Single Transverse Axillary Incision

Cited by 20 publications

References 28 publications

Latissimus dorsi muscle flap transfer through endoscopic approach combined with the implant after tissue expansion for breast reconstruction of mastectomy patients

Latissimus dorsi muscle flap transfer through endoscopic approach combined with the implant after tissue expansion for breast reconstruction of mastectomy patients

Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI

Breast Reconstruction Using a Three-Dimensional Absorbable Mesh Scaffold and Autologous Fat Grafting: A Composite Strategy Based on Tissue-Engineering Principles

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