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논문 기본 정보

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학술저널
저자정보
Feng, Jiajun (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) Pardoe, Cleone I (College of Medical and Dental Sciences, University of Birmingham) Mota, Ashley Manuel (Hull and East Yorkshire Trust) Chui, Christopher Hoe Kong (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) Tan, Bien-Keem (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital)
저널정보
대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제43권 제2호
발행연도
2016.1
수록면
197 - 203 (7page)

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Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.
#Breast #Reconstructive surgical procedures #Tissue expansion #Surgical flaps #Radiotherapy

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참고문헌 (11)

참고문헌 신청
Giacalone PL / 2002 / Achieving symmetry in unilateral breast reconstruction: 17 years experience with 683 patients / Aesthetic Plast Surg 26:299~302 google schola Slavin SA / 1994 / Improving the latissimus dorsi myocutaneous flap with tissue expansion / Plast Reconstr Surg 93:811~824 google schola Vrieling C / 1999 / Validation of the me-thods of cosmetic assessment after breast-conserving therapy in the EORTC “boost versus no boost” trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. European Organization for Research and Treatment of Cancer / Int J Radiat Oncol Biol Phys 45:667~676 google schola Hammond DC / 2007 / Latissimus dorsi flap breast reconstruction / Clin Plast Surg 34:75~82 google schola Germann G / 1996 / Breast reconstruction with the extended latissimus dorsi flap / Plast Reconstr Surg 97:519~526 google schola

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