Immediate Breast Reconstruction with a Latissimus Dorsi Flap Has No Detrimental Effects on Shoulder Motion or Postsurgical Complications up to 1 Year after Surgery

Abstract

Therapeutic, II.

The musculoskeletal consequences of breast reconstruction using the latissimus dorsi muscle for women following mastectomy for breast cancer: A critical review

“…They suggested that any reductions in shoulder ROM were possibly due to mastectomy alone and that LD breast reconstruction had no additional detrimental effects on shoulder function; however, as no long term follow up was carried out these findings can only be associated with the expected short term recovery of shoulder ROM in the immediate post-operative period. In the follow-up study by de Oliveira, do Nascimento, Derchain, and Sarian (2013), they reexamined recovery of shoulder ROM during the first year following immediate LD breast reconstruction. Shoulder ROM was assessed in patients (n = 47) before, after 1 month and at 3, 6 and 12 months following LD breast reconstruction.…”

“…Objective measurements have portrayed varying results, however, a commonality between studies is that most report significant deficits in the immediate post-operative period (Eyjolfsdottir et al, 2016;Forthomme et al, 2010;Kim et al, 2013;Yang et al, 2015), with results demonstrating a gradual recovery over time (de Oliveira et al, 2013;Glassey et al, 2008). Studies have implemented a wide range of assessment techniques including objective measurements of shoulder function, and subjective evaluations by patients and their clinicians.…”

“…Studies have implemented a wide range of assessment techniques including objective measurements of shoulder function, and subjective evaluations by patients and their clinicians. Objective measurements have portrayed varying results, however, a commonality between studies is that most report significant deficits in the immediate post-operative period (Eyjolfsdottir et al, 2016;Forthomme et al, 2010;Kim et al, 2013;Yang et al, 2015), with results demonstrating a gradual recovery over time (de Oliveira et al, 2013;Glassey et al, 2008). A number of subjective evaluations suggest low morbidity with minimal functional impact (Garusi et al, 2016;Kaarianinen et al, 2014;Losken et al, 2010), however, in a retrospective survey, findings reported that women can sustain impaired shoulder strength and reduced function long term, with some women reporting moderate to severe impairment in daily activity more than 10 years following surgery (Tarantino et al, 2006).…”

“…In the follow-up study by de Oliveira, do Nascimento, Derchain, and Sarian (2013), they reexamined recovery of shoulder ROM during the first year following immediate LD breast reconstruction. The authors found that at the end of the follow-up period, women in both groups had an average reduction of 30° in their shoulder ROM compared with baseline.…”

Transverse Upper Gracilis Flap with Implant In Postmastectomy Breast Reconstruction: a Case Report

“…With reference to the scar, a slight caudal migration from the gluteal crease may sometimes occur. Should the patient complain, this imperfection can be corrected by refixation of the gluteal fold to the deep fascia of the tuber ischiaticum …”