TRAM Flap Anatomy Correlated with a 10-Year Clinical Experience with 556 Patients

Pa, Watterson; Bostwick, John; Tr, Hester; Jt, Bried; Gi, Taylor

doi:10.1097/00006534-199506000-00007

Cited by 182 publications

(62 citation statements)

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“…The mean follow-up was 8 years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Five patients were lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…In this study, chest wall irradiation resulted in a statistically significant increase in both fat necrosis and flap necrosis. 19 Bipedicled flaps showed a reduced risk of necrosis, suggesting that improved blood supply may overcome some of the effects of RT. Moreover, internal mammary lymph nodes are frequently irradiated in postmastectomy RT.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

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Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study

Monrigal

Dauplat

Gimbergues

et al. 2011

European Journal of Surgical Oncology (EJSO)

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PurposeTo evaluate the feasability of immediate breast reconstruction (IBR) following mastectomy after neoadjuvant chemotherapy (NACT) and radiation therapy (RT) for operable invasive breast cancer (OIBC), in terms of incidence of local complications, locoregional control and survival. Patients and methodsFrom 1990 to 2008, 210 patients were treated by NACT, RT and mastectomy with IBR for OIBC. One hundred and seven patients underwent a latissimus dorsi flap with implant (LDI), 56 patients a transverse rectus abdominis musculocutaneous (TRAM) flap, 25 an autologous latissimus dorsi flap (ALD) and 22, a retropectoral implant (RI) reconstruction. ResultsForty-six (21,9%) early events were recorded: 20 necrosis, 9 surgical site infections and 6 haematomas, requiring further surgery in 23 patients. More necrosis were observed with TRAM flap reconstructions (p=0,000004), requiring more surgical revision than LD reconstructions. Seromas represented 42% of early complications in LD reconstructions. Fifty-five patients presented with late complications (26,2%) with mainly implant complications (capsular contracture, infection, dislocation, deflation) (23,6%), requiring reintervention in 14 cases. There were more delayed surgical revisions in RI reconstructions (p=0,0005). The 5 years overall and disease-free survival rates were respectively 86,7% and 75,6%. Sixty-four patients presented at least one recurrence (30,5%) with 5 local , 9 locoregional and 54 distant relapses. ConclusionThis therapeutic sequence does not seem to increase the IBR morbidity nor alter disease-free and overall survival.

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“…The mean follow-up was 8 years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Five patients were lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study

Monrigal

Dauplat

Gimbergues

et al. 2011

European Journal of Surgical Oncology (EJSO)

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show abstract

“…10 The reluctance of many surgeons to combine skinsparing mastectomy with TRAM flap reconstruction, using LD flaps or sub-pectoral implants in preference, may be a reflection of several factors including inexperience and the characteristics of the patient population. TRAM flap reconstruction is associated with a poor outcome when the surgeon is relatively inexperienced 11 and few breast surgeons will have had the opportunity to gain sufficient experience.…”

Section: Discussionmentioning

confidence: 99%

Skin-sparing mastectomy in the UK – a review of current practice

Sotheran¹,

Rainsbury²

2004

Ann R Coll Surg Engl

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“…[4][5][6][7][8][9][10] The recent popularity of the deep inferior epigastric perforator (DIEP) flap where the blood vessels are dissected free from the rectus muscle that is left in situ significantly reduces the postoperative abdominal complications.…”

Section: -3mentioning

confidence: 99%

A new approach to preexisting vertical midline abdominal scars with crossover DIEP flap breast reconstruction

2009

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Breast reconstruction using a free transverse rectus abdominis myocutaneous flap or a deep inferior epigastric perforator (DIEP) flap is a challenge in patients with a vertical midline abdominal scar due to the poor perfusion of the lower abdominal skin ellipse across the midline. In such patients, only one half of the abdominal skin ellipse can be used with certainty, and this limits the amount of tissue available for reconstructing the breast. Two cases of breast reconstruction in patients with a lower midline abdominal scar are presented using the DIEP flap, in which the poor perfusion across the midline scar was overcome by a technique of crossover anastomoses between the two deep inferior epigastric pedicles. Reliable perfusion of the entire lower abdominal skin ellipse was achieved. This crossover anastomoses technique overcomes the poor perfusion imposed by the vertical midline abdominal scar and enables DIEP flap breast reconstruction to be offered to women with midline abdominal scars.

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TRAM Flap Anatomy Correlated with a 10-Year Clinical Experience with 556 Patients

Cited by 182 publications

References 0 publications

Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study

Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study

Skin-sparing mastectomy in the UK – a review of current practice

A new approach to preexisting vertical midline abdominal scars with crossover DIEP flap breast reconstruction

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