Effect of postoperative radiotherapy on autologous deep inferior epigastric perforator flap volume after immediate breast reconstruction

Chatterjee, Justin S.; Lee, A.; Anderson, William F.; Baker, Lee D.; Stevenson, J.H.; Dewar, John; Thompson, Alastair

doi:10.1002/bjs.6693

Cited by 83 publications

(58 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, the radiation eVect may have had a greater inXuence on the volume decrease in ALTF patients compared with PMMCF patients. However, the eVect of radiation on the Xap volume change remains controversial [14,15], and our univariate analysis result revealed that radiation did not signiWcantly aVect the volume change. Additionally, the pedicled Xap has been reported to have more tolerance to the radiation eVect on an entire Xap contracture to maintain its volume compared with the free Xap [16].…”

Section: Discussionmentioning

confidence: 98%

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Cho

Joo

Sun

et al. 2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Postoperative volume changes in reconstructed flaps are known to influence the functional restoration of resected areas of the upper aerodigestive tract. The purposes of this study were to estimate the volume decreases in flaps and investigate clinical factors affecting the volume decrease. The medical records of 19 patients who underwent ablation and flap reconstruction surgeries for head and neck cancers were reviewed. The volume of the reconstructed flap was measured at 3, 12, and 24 months postoperatively using CT or MR imaging and the 3D-DOCTOR software. The relationships between volume changes and perioperative clinical parameters were examined. The primary tumor locations were the nasal cavity and paranasal sinus, oropharynx, oral cavity, and hypopharynx in 8, 6, 4, and 1 case, respectively. Twelve patients underwent anterolateral thigh flap (ALTF) reconstruction, and seven patients underwent pectoralis major myocutaneous flap (PMMCF) reconstruction. Twelve (63.2%) patients received postoperative radiation. The estimated volume decreases at 12 and 24 months postoperatively for ALTF were 20.9 and 24.8%, respectively, while those for PMMCF were 7.3 and 10.8%, respectively. Among clinical factors, only the type of flap affected the volume change. When determining the volume of reconstructed flaps, the type of flap must be considered. It was recommended to make free and regional flaps at least 20 and 10% larger, respectively than the actual defect.

show abstract

Section: Discussionmentioning

confidence: 98%

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Cho

Joo

Sun

et al. 2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Some studies evaluating immediate autologous tissue-based reconstruction before PMRT have reported reasonable rates of complications and satisfactory cosmetic outcomes. 6,29,30,38 However, overall complication rates are often imprecisely defined, as reported overall complications may include complications at both the donor and recipient sites. 39 Even overall complication rates for only the recipient site are not significantly affected by PMRT, especially since radiation therapy is not typically begun until 1 or 2 months after the transfer of the microvascular flap.…”

Section: Discussionmentioning

confidence: 99%

“…These surgeons have found the deleterious effects of PMRT to be acceptable and preferable to the delay in reconstruction and additional surgery required for the staged approach. 6,12,[26][27][28][29][30] Others have suggested that breast reconstruction with an MS FTRAM flap rather than a DIEP flap will avoid or decrease the deleterious effects of radiation because MS FTRAM flaps have a more robust blood supply. 31 However, it is not known whether irradiated MS FTRAM flaps experience less fat necrosis and fibrosis than irradiated DIEP flaps.…”

Section: Introductionmentioning

confidence: 99%

Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Garvey¹

2016

Breast Reconstruction

View full text Add to dashboard Cite

show abstract

“…Radiotherapy after mastectomy but before reconstruction has not been shown to increase complications after autologous reconstruction (25); however, not all studies are in agreement (26,27). Certain studies show that postoperative radiotherapy to the breast reconstructed with a deep inferior epigastric perforator flap (DIEP) or transverse rectus abdominis myocutaneous (TRAM) flap has no effect on the reconstruction (28,29), while several others show a considerable negative effect on the final results of autologous reconstruction (24,26,(30)(31)(32)(33)(34).…”

Section: The Effect Of Radiotherapy On Breast Reconstructionmentioning

confidence: 99%

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

et al. 2017

View full text Add to dashboard Cite

being, health-related quality of life and satisfaction (5,7-10).Patients' satisfaction and health-related quality of life are frequently used as parameters for outcome measurement in plastic surgery. Postoperative complications after breast reconstruction are common and affect patient satisfaction.Determining independent risk factors using patient characteristics could be advantageous for patient assessment and counseling. 2.05, 95% confidence interval (CI) 1.25-3.37, P=0.0005], followed by body mass index (BMI) (OR 1.07, 95% CI 1.01-1.13, P=0.017). High BMI was associated with the highest number of late overall postoperative complications (OR 1.06, 95% CI 1.00-1.11, P=0.042), followed by history of radiotherapy (OR 1.66, 95% CI 1.01-2.74, P=0.046). When the risk factors were combined, the risk for postoperative complications rose exponentially.Conclusions: Our results provide evidence that patients should cease smoking and overweight patients should lose weight before undergoing breast reconstruction. Additionally, if the patient has received radiotherapy, the reconstruction method should be carefully chosen. High BMI, history of radiotherapy, and smoking are independent risk factors for many types of both early and late postoperative complications in breast reconstructive surgery. Combining these risk factors multiplies the risk of postoperative complications.

show abstract

Effect of postoperative radiotherapy on autologous deep inferior epigastric perforator flap volume after immediate breast reconstruction

Abstract: In this study postoperative radiotherapy did not significantly affect breast volume after DIEP flap reconstruction. The potential need for postoperative radiotherapy should not deter women from undergoing immediate DIEP flap breast reconstruction.

Cited by 83 publications

References 17 publications

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Patient determinants as independent risk factors for postoperative complications of breast reconstruction

Contact Info

Product

Resources

About