Application of Extended Latissimus Dorsi Flap in Immediate Breast Reconstruction after Modified Radical Mastectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yabing , CHEN Jianping , CHEN Bin.

Department of NeckBreast Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui Province, China;

Corresponding author：

Keywords：

Breast cancer; Modified radical mastectomy; Extended latissimus dorsi flap; Immediate breast reconstruction

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the value of extended latissimus dorsi flap (ELDF) in immediate breast reconstruction in patients with breast cancer after modified radical mastectomy.
Methods Thirty-six patients with breast cancer who accepted modified radical mastectomy and 12 patients with breast cancer who accepted immediate breast reconstruction after modified radical mastectomy from January 2008 to June 2009 were included. The complications, cosmetical results and quality of life of these patients were compared. The shape of breast reconstruction was also evaluated.
Results All of 12 patients succeeded in proceeding immediate breast reconstruction with ELDF. The evaluation of shape of breast reconstruction was good in 6 cases, secondary in 4 cases, and bad in 2 cases, which was beyond that in patients of radical operation group (P lt;0.001). There was no statistical difference in operation complications as hydrops, necrosis, affecting limb shoulder joint motion, drainage time, hospital stay, and starting time for adjuvant therapy between two groups (P gt;0.05). The patients in breast reconstruction group had a better quality of life compared with the patients in radical operation group (P lt;0.001). In breast reconstruction group, 10 patients received adjuvant chemoradiotherapy and no necrosis was showed in local flap grafting. After the follow-up of 2-17 months (median 8 months), no local recurrence and metastasis was demonstrated in two groups patients.
Conclusions There are good cosmetic results after immediate breast reconstruction with ELDF, and it is easy to operate. It is a safe and feasible therapeutics method for early breast cancer.

Citation： WANG Yabing,CHEN Jianping,CHEN Bin.. Application of Extended Latissimus Dorsi Flap in Immediate Breast Reconstruction after Modified Radical Mastectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(7): 735-738. doi: Copy

1.	郭娜, 倪毅, 关炜. 乳房再造术的研究进展 [J]. 山西中医学院学报, 2008; 9(1): 6062.
2.	尹健, 张学慧, 张斌. 即刻乳房再造与延期乳房再造的心理调查 [J]. 中华整形外科杂志, 2005; 21(3): 175177.
3.	狄根红, 亓发芝, 吴炅, 等. 乳腺癌改良根治术后一期乳房再造 [J]. 复旦学报(医学版), 2004; 31(4): 434435.
4.	Neyt MJ, Blondeel PN, Morrison CM, et al. Comparing the cost of delayed and immediate autologous breast reconstruction in Belgium [J]. Br J Plast Surg, 2005; 58(4): 493497.
5.	AlGhazal SK, Sully L, Fallowfield L, et al. The psychological impact of immediate rather than delayed breast reconstruction [J]. Eur J Surg Oncol, 2000; 26(1): 1719.
6.	Mortenson MM, Schneider PD, Khatri VP, et al. Immediate breast reconstruction after mastectomy increases wound complications: however, initiation of adjuvant chemotherapy is not delayed [J]. Arch Surg, 2004; 139(9): 988991.
7.	Wilson CR, Brown IM, WeillerMithoff E, et al. Immediate breast reconstruction does not lead to a delay in the delivery of adjuvant chemotherapy [J]. Eur J Surg Oncol, 2004; 30(6): 624627.
8.	韩久卉, 张英泽. 乳房切除后乳房再造的意义及现状 [J]. 中华整形外科杂志, 2004; 20(6): 468471.
9.	苟扬, 任国胜, 厉红元. 规范化保乳手术在乳腺癌治疗中的应用 [J]. 中国普外基础与临床杂志, 2009; 16(1): 7780.
10.	Borger J, Kemperman H, Hart A, et al. Risk factors in breastconservation therapy [J]. J Clin Oncol, 1994; 12(4): 653660.
11.	Chagpar A, Langstein HN, Kronowitz SJ, et al. Treatment and outcome of patients with chest wall recurrence after mastectomy and breast reconstruction [J]. Am J Surg, 2004; 187(2): 164169.
12.	Langstein HN, Cheng MH, Singletary SE, et al. Breast cancer recurrence after immediate reconstruction: patterns and significance [J]. Plast Reconstr Surg, 2003; 111(2): 712722.
13.	Murphy RX Jr, Wahhab S, Rovito PF, et al. Impact of immediate reconstruction on the local recurrence of breast cancer after mastectomy [J]. Ann Plast Surg, 2003; 50(4): 333338.
14.	邵志敏, 余科达. 乳腺外科的发展趋势 [J]. 中国普外基础与临床杂志, 2007; 14(3): 252254.
15.	Downes KJ, Glatt BS, Kanchwala SK, et al. Skinsparing mastectomy and immediate reconstruction is an acceptable treatment option for patients with highrisk breast carcinoma [J]. Cancer, 2005; 103(5): 906913.
16.	Hill O, White K. Exploring women’s experiences of TRAM flap breast reconstruction after mastectomy for breast cancer [J]. Oncol Nurs Forum, 2008; 35(1): 8188.
17.	Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy [J]. Lancet, 1983; 1(8322): 459462.
18.	邹天宁, 汤学良, 陈德滇, 等. 乳腺癌术后即刻乳房修复和重建的临床研究 [J]. 中国癌症杂志, 2009; 19(8): 644646.
19.	Sternberg EG, Perdikis G, McLaughlin SA, et al. Latissimus dorsi flap remains an excellent choice for breast reconstruction [J]. Ann Plast Surg, 2006; 56(1): 3135.
20.	亓发芝, 陈君雪, 狄根红, 等. 扩大背阔肌肌皮瓣乳房再造 [J/CD]. 中华乳腺病杂志（电子版）, 2007; 1(6): 210213.
21.	康骅, 海涛, 蔡伟, 等. 扩大背阔肌肌皮瓣在乳腺癌即刻乳房再造中的应用 [J]. 首都医科大学学报, 2007; 28(1): 2325.
22.	Soong IS, Yau TK, Ho CM, et al. Postmastectomy radiotherapy after immediate autologous breast reconstruction in primary treatment of breast cancers [J]. Clin Oncol (R Coll Radiol), 2004; 16(4): 283289.
23.	Delay E, Gounot N, Bouillot A, et al. Autologous latissimus breast reconstruction: a 3year clinical experience with 100 patients [J]. Plastic Reconstr Surg, 1998; 102(5): 14611478.
24.	徐华, 董佳生, 王露萍, 等. 乳房再造计算机辅助设计系统的开发和临床应用 [J]. 组织工程与重建外科杂志, 2008; 4(2): 9496.
25.	牛兆河, 栾杰, 穆大力, 等. 背阔肌肌皮瓣乳房再造术后腋前皱襞的重建 [J]. 中国美容医学, 2007; 16(3): 319321.

1. 郭娜, 倪毅, 关炜. 乳房再造术的研究进展 [J]. 山西中医学院学报, 2008; 9(1): 6062.
2. 尹健, 张学慧, 张斌. 即刻乳房再造与延期乳房再造的心理调查 [J]. 中华整形外科杂志, 2005; 21(3): 175177.
3. 狄根红, 亓发芝, 吴炅, 等. 乳腺癌改良根治术后一期乳房再造 [J]. 复旦学报(医学版), 2004; 31(4): 434435.
4. Neyt MJ, Blondeel PN, Morrison CM, et al. Comparing the cost of delayed and immediate autologous breast reconstruction in Belgium [J]. Br J Plast Surg, 2005; 58(4): 493497.
5. AlGhazal SK, Sully L, Fallowfield L, et al. The psychological impact of immediate rather than delayed breast reconstruction [J]. Eur J Surg Oncol, 2000; 26(1): 1719.
6. Mortenson MM, Schneider PD, Khatri VP, et al. Immediate breast reconstruction after mastectomy increases wound complications: however, initiation of adjuvant chemotherapy is not delayed [J]. Arch Surg, 2004; 139(9): 988991.
7. Wilson CR, Brown IM, WeillerMithoff E, et al. Immediate breast reconstruction does not lead to a delay in the delivery of adjuvant chemotherapy [J]. Eur J Surg Oncol, 2004; 30(6): 624627.
8. 韩久卉, 张英泽. 乳房切除后乳房再造的意义及现状 [J]. 中华整形外科杂志, 2004; 20(6): 468471.
9. 苟扬, 任国胜, 厉红元. 规范化保乳手术在乳腺癌治疗中的应用 [J]. 中国普外基础与临床杂志, 2009; 16(1): 7780.
10. Borger J, Kemperman H, Hart A, et al. Risk factors in breastconservation therapy [J]. J Clin Oncol, 1994; 12(4): 653660.
11. Chagpar A, Langstein HN, Kronowitz SJ, et al. Treatment and outcome of patients with chest wall recurrence after mastectomy and breast reconstruction [J]. Am J Surg, 2004; 187(2): 164169.
12. Langstein HN, Cheng MH, Singletary SE, et al. Breast cancer recurrence after immediate reconstruction: patterns and significance [J]. Plast Reconstr Surg, 2003; 111(2): 712722.
13. Murphy RX Jr, Wahhab S, Rovito PF, et al. Impact of immediate reconstruction on the local recurrence of breast cancer after mastectomy [J]. Ann Plast Surg, 2003; 50(4): 333338.
14. 邵志敏, 余科达. 乳腺外科的发展趋势 [J]. 中国普外基础与临床杂志, 2007; 14(3): 252254.
15. Downes KJ, Glatt BS, Kanchwala SK, et al. Skinsparing mastectomy and immediate reconstruction is an acceptable treatment option for patients with highrisk breast carcinoma [J]. Cancer, 2005; 103(5): 906913.
16. Hill O, White K. Exploring women’s experiences of TRAM flap breast reconstruction after mastectomy for breast cancer [J]. Oncol Nurs Forum, 2008; 35(1): 8188.
17. Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy [J]. Lancet, 1983; 1(8322): 459462.
18. 邹天宁, 汤学良, 陈德滇, 等. 乳腺癌术后即刻乳房修复和重建的临床研究 [J]. 中国癌症杂志, 2009; 19(8): 644646.
19. Sternberg EG, Perdikis G, McLaughlin SA, et al. Latissimus dorsi flap remains an excellent choice for breast reconstruction [J]. Ann Plast Surg, 2006; 56(1): 3135.
20. 亓发芝, 陈君雪, 狄根红, 等. 扩大背阔肌肌皮瓣乳房再造 [J/CD]. 中华乳腺病杂志（电子版）, 2007; 1(6): 210213.
21. 康骅, 海涛, 蔡伟, 等. 扩大背阔肌肌皮瓣在乳腺癌即刻乳房再造中的应用 [J]. 首都医科大学学报, 2007; 28(1): 2325.
22. Soong IS, Yau TK, Ho CM, et al. Postmastectomy radiotherapy after immediate autologous breast reconstruction in primary treatment of breast cancers [J]. Clin Oncol (R Coll Radiol), 2004; 16(4): 283289.
23. Delay E, Gounot N, Bouillot A, et al. Autologous latissimus breast reconstruction: a 3year clinical experience with 100 patients [J]. Plastic Reconstr Surg, 1998; 102(5): 14611478.
24. 徐华, 董佳生, 王露萍, 等. 乳房再造计算机辅助设计系统的开发和临床应用 [J]. 组织工程与重建外科杂志, 2008; 4(2): 9496.
25. 牛兆河, 栾杰, 穆大力, 等. 背阔肌肌皮瓣乳房再造术后腋前皱襞的重建 [J]. 中国美容医学, 2007; 16(3): 319321.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Extended Latissimus Dorsi Flap in Immediate Breast Reconstruction after Modified Radical Mastectomy

Abstract Full text Figures/Tables Video References Cited by

Format

Content