Immediate TRAM Flap Breast Reconstruction

Lf, Elliott; Eskenazi, Loren; Ph, Beegle; Pe, Podres; Dražan, Luboš

doi:10.1097/00006534-199308000-00004

Cited by 140 publications

(49 citation statements)

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“…Although these techniques presents positive aspects some limitations have arisen regarding the muscle resection [83][84][85][86][87][88] . Thus, alternatively free tissue transfer including the deep inferior epigastric perforator (DIEP), pedicled thoracodorsal perforator flap (TAP), free TRAM or the gluteal artery perforator (GAP) flaps can be indicated with a lower donor site morbidity.…”

Section: Reconstructive Aspectsmentioning

confidence: 99%

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Munhoz

Montag

Filassi

et al. 2014

WJCO

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Nipple-sparing mastectomy (NSM) is a safe technique in patients who are candidates for conservation breast surgery. However, there is worry concerning its oncological safety and surgical outcome in terms of postoperative complications. The authors reviewed the literature to evaluate the oncological safety, patient selection, surgical techniques, and also to identify the factors influencing postoperative outcome and complication rates. Patient selection and safety related to NSM are based on oncological and anatomical parameters. Among the main criteria, the oncological aspects include the clinical stage of breast cancer, tumor characteristics and location including small, peripherally located tumors, without multicentricity, or for prophylactic mastectomy. Surgical success depends on coordinated planning with the oncological surgeon and In general, the NSM reconstruction is related to autologous and alloplastic techniques and sometimes include contra-lateral breast surgery. Choice of reconstructive technique following NSM requires accurate consideration of various patient related factors, including: breast volume, degree of ptosis, areola size, clinical factors, and surgeon's experience. In addition, tumor related factors include dimension, location and proximity to the nipple-areola complex. Regardless of the fact that there is no unanimity concerning the appropriate technique, the criteria are determined by the surgeon' s experience and the anatomical aspects of the breast. The positive aspects of the technique utilized should include low interference with the oncological treatment, reproducibility, and long-term results. Selected patients can have safe outcomes and therefore this may be a feasible option for early breast cancer management. However, available data demonstrates that NSM can be safely performed for breast cancer treatment in selected cases. Additional studies and longer follow-up are necessary to define consistent selection criteria for NSM.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast reconstruction; Skin-sparing mastectomy; Nipple-sparing mastectomy; Outcome; Complications; Silicone breast implants; Tissue expanders; Oncoplastic surgery Core tip: In selected patients, nipple-sparing mastectomy (NSM) has allowed an adequate oncologic control with satisfactory aesthetic outcome. In addition, utilizing the native breast skin optimizes the aesthetic outcome of the reconstructed breast and minimizes postmastectomy deformity. The satisfactory results are due to a close collaboration with the oncological surgical ed the technique for benign diseases, however he did not report the procedure for oncological objectives or as a risk-reduction alternative [10,11] . Recently, there has been an increase in clinical experience studies of NSM for breast cancer prophylaxis or early cancer treatment, evidencing revived interest in this surgical procedure [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][33][34][35][36][37][38][39][40][41][42][43...

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Section: Reconstructive Aspectsmentioning

confidence: 99%

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Munhoz

Montag

Filassi

et al. 2014

WJCO

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“…The free TRAM has a better blood supply than the undelayed pedicled TRAM and vascularised transfers should be the preferred option for high-risk patients (including smokers and obese patients) especially if post-operative radiotherapy is likely to be given (155), and if delayed reconstruction is decided against.…”

Section: Radiotherapy and Autologous Reconstruction: Tram Flapsmentioning

confidence: 99%

Consensus and Controversy in Breast Reconstruction a Review of Current Opinion and Practice

Khoo¹,

Ragoowansi

2008

Polish Journal of Surgery

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“…The names of these vessels are those used in widespread surgical nomenclature, albeit not in Terminologia Anatomica. Each of these procedures have unique benefits and pitfalls, but when selected and executed appropriately, share the result of a safe, well-vascularized flap for reconstruction (Allen and Treece, 1994;Blondeel, 1999;Elliott et al, 1993;Lindsey, 2007;Spiegel and Khan, 2007;Taylor, 1999). However, there are circumstances where this safety may be compromised.…”

Section: Introductionmentioning

confidence: 99%

The effect of anterior abdominal wall scars on the vascular anatomy of the abdominal wall: A cadaveric and clinical study with clinical implications

et al. 2009

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The anterior abdominal wall integument is frequently used in a range of reconstructive flaps. These tissues are supplied by the deep and superficial inferior epigastric arteries (DIEA and SIEAs) and the deep and superficial superior epigastric arteries (DSEA and SSEAs). Previous abdominal wall surgery alters this vascular anatomy and may influence flap design. One hundred and sixty-eight patients underwent abdominal wall computed tomographic angiography (CTA) for preoperative imaging. Fifty-eight of these patients had undergone previous abdominal surgery, and were assessed for scar pattern and relationship to the course and distribution of all major axial vessels and perforators. Two cadaveric abdominal wall specimens with midline abdominal scars underwent contrast injection of the DIEAs and DSEAs, with subsequent CTA. The course and distribution of all cutaneous vessels were assessed. In all clinical and cadaveric cases, the vasculature of the abdominal wall had been altered by previous surgery. In the clinical cases, vascular architecture was universally altered in the region of the scar, often modifying the filling patterns of the abdominal wall and occasionally precluding the use of an abdominal wall flap. In both cadaveric specimens, regions of non-filling were evident upon contrast injection, highlighting the angiosomes not supplied by the DIEA or DSEA. Previous abdominal wall surgery necessarily alters the vascular architecture of the abdominal wall, and may alter the source vessels supplying cutaneous tissues. CTA was useful in identifying and delineating these changes, and may be used as a preoperative tool in this role.

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Immediate TRAM Flap Breast Reconstruction

Cited by 140 publications

References 0 publications

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Consensus and Controversy in Breast Reconstruction a Review of Current Opinion and Practice

The effect of anterior abdominal wall scars on the vascular anatomy of the abdominal wall: A cadaveric and clinical study with clinical implications

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