Thoracodorsal artery perforator flap, muscle-sparing latissimus dorsi, and descending branch latissimus dorsi: A multicenter retrospective study on early complications and meta-analysis of the literature

Gatto, Arianna; Parisi, Paola; Brambilla, Leonardo; Simonelli, Ilaria; Vestri, Annarita; Torto, Federico Lo; Giovanazzi, Riccardo; Marchesi, Andrea

doi:10.1016/j.bjps.2022.06.083

Cited by 10 publications

(6 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Significantly, the SAII variation described herein crosses directly through this zone, and as such would be in danger of being injured during an axillary dissection. Success of the latissimus dorsi flap, utilized in breast reconstruction both as a pedicled and as a free flap, is dependent upon the knowledge of the vascular anatomy [ 13 ]. Anatomical variations have significant implications for latissimus dorsi flap procedures (LDFP) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual Vascular Distribution in the Third Segment of the Axillary Artery

Ramos-Alicea,

Marcano-Anaya,

Loomis

et al. 2023

Medicina

View full text Add to dashboard Cite

The third segment of the axillary artery (TSAA) is the main vascular supply to the muscles of the upper limb. Numerous studies have reported atypical branching patterns of the TSAA, which can complicate operative interventions involving structures supplied by this segment of the artery. Our current study evaluated a previously undescribed branching pattern in the TSAA, in which the subscapular artery gave rise to an unusual posterior humeral circumflex artery, and a second subscapular artery. In addition, a third variant was found in the origin of the thoracodorsal artery: two collateral horizontal arteries supplying the deep medial surface of the latissimus dorsi muscle. Vascular anatomical variants may affect the classical upper limb interventions requiring modification of the traditional surgical approaches. This case report aims to evaluate these variants from a clinical perspective regarding the management of upper limb trauma, axillary, breast, and muscle flap surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Unusual Vascular Distribution in the Third Segment of the Axillary Artery

Ramos-Alicea,

Marcano-Anaya,

Loomis

et al. 2023

Medicina

View full text Add to dashboard Cite

show abstract

“…The TDAP flap has the same pedicle as the latissimus dorsi muscle flap. However, since the skin is only lifted over the perforator and the muscle is left intact, donor site complications are less [23]. It is a more difficult surgery compared to the latissimus dorsi flap, and its learning curve is longer than the latissimus dorsi flap.…”

Section: Perforator Flapsmentioning

confidence: 99%

Solutions in Breast Reconstruction

Karakol¹,

Noyan²,

Ömer³

2023

Breast Cancer Updates

View full text Add to dashboard Cite

Breast reconstruction, after cancer surgery, is not only a reconstructive surgery but also an esthetic surgery. No woman should be expected to give up the breast tissue, which is the symbol of female identity, easily. The reconstruction stage after breast cancer is difficult enough in the early and late stages. It is generally not possible to cover the defect and to equalize the two breasts in a single step. General surgery and plastic surgery should work together. Recently, innovative solutions have been offered in breast reconstruction. Starting from skin grafts and local flaps, various flap options, dermal equivalents, fat transfer, and tissue expansion operations are among the options. Breast reconstruction is difficult enough in breasts that have undergone radiotherapy, and reconstruction with autologous tissue is preferred.

show abstract

“…On the other hand, volume replacement techniques are preferred in patients with inadequate residual breast tissue to restore shape and contour or in smaller-breasted patients that wish to preserve breast size. The most common volume replacement techniques utilize regional tissue based on chest wall perforators including the intercostal vessels, thoracodorsal and lateral thoracic vessel and internal mammary perforators (9)(10)(11)(12)(13)(14)(15)(16). In certain select cases, free tissue transfer for volume replacement also serves as an excellent technique to restore shape and contour.…”

Section: Introductionmentioning

confidence: 99%

Microsurgery in oncoplastic breast reconstruction

Salibian¹,

Patel²

2023

Gland Surg

View full text Add to dashboard Cite

Oncoplastic breast reconstruction has allowed for the optimization of oncologic and reconstructive outcomes after breast-conserving surgery (BCS). Volume replacement procedures in oncoplastic reconstruction most commonly utilize regional pedicled flaps, though several studies have reported benefits to free tissue transfer for oncoplastic partial breast reconstruction in the immediate, delayed-immediate and delayed settings. Microvascular oncoplastic breast reconstruction is a useful technique in the appropriate patients with small-to-medium size breasts and larger tumor-to-breast ratios who desire to preserve breast size, those with a paucity of regional breast tissue and patients that wish to avoid chest wall and back scars. Several free flap options for partial breast reconstruction exist, including superficially-based abdominal flaps, medial thigh-based flaps, deep inferior epigastric artery perforator (DIEP) flaps and thoracodorsal artery-based flaps. However, special consideration should be given to preserving donor sites for potential future total autologous breast reconstruction with any flap choice that should be tailored to individual recurrence risk. Aesthetically placed incisions should take recipient vessel access into consideration which include the internal mammary vessels and perforators medially, and then intercostal, serratus branch and thoracodorsal vessels laterally. The utilization of a thin strip of lower abdominal tissue based on the superficial abdominal circulation allows for a well-concealed donor site with minimal morbidity and preservation of the abdominal donor site if future total autologous breast reconstruction is needed.Optimizing outcomes requires a team-based approach to appropriately design recipient and donor-site considerations while individualizing tumor and patient-specific plans.

show abstract

Thoracodorsal artery perforator flap, muscle-sparing latissimus dorsi, and descending branch latissimus dorsi: A multicenter retrospective study on early complications and meta-analysis of the literature

Cited by 10 publications

References 53 publications

Unusual Vascular Distribution in the Third Segment of the Axillary Artery

Unusual Vascular Distribution in the Third Segment of the Axillary Artery

Solutions in Breast Reconstruction

Microsurgery in oncoplastic breast reconstruction

Contact Info

Product

Resources

About