Anterior-First Approach for Latissimus Dorsi Myocutaneous Flap Breast Reconstruction: A Refined Elevation Method with Detailed Video Instructions
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics Statement and Patient Selection
2.2. Study Design
2.3. Statistical Analysis
2.4. Operative Procedure
3. Results
3.1. Demographic and Oncologic Data
3.2. Operative Outcomes Data
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Anterior-First Approach, n = 28 1 | Conventional Approach, n = 20 1 | p-Value 2 |
---|---|---|---|
Age | 45 (40, 51) | 42 (38, 48) | 0.2 |
Type of mastectomy | <0.001 | ||
MRM | 1 (3.6%) | 7 (35%) | |
NSM | 14 (50%) | 1 (5.0%) | |
SSM | 13 (46%) | 12 (60%) | |
BMI | 21.8 (20.9, 24.2) | 20.0 (19.1, 21.3) | 0.004 |
DM | 1 (3.6%) | 0 (0%) | >0.9 |
Smoking | 0 (0%) | 0 (0%) | |
Adjuvant chemotherapy | 3 (11%) | 2 (10%) | >0.9 |
Axillary node dissection | 6 (21%) | 11 (55%) | 0.017 |
Mastectomy weight | 247 (161, 341) | 235 (150, 303) | 0.8 |
Flap surface area | 68 (51, 75) | 82 (77, 93) | 0.010 |
Operative Phase | Anterior-First Approach | Conventional Approach |
---|---|---|
Flap elevation | 1st sub-phase: Elevation of axillary and lateral portion of LDMC flap without position change | N/A |
Position change | Position change (supine → lateral) | Position change (supine → lateral) |
Flap elevation | 2nd sub-phase: Elevate remaining distal area of the flap | Initiation of flap elevation from the lateral position |
Position change | Position change (lateral → supine) | Position change (lateral → supine) |
Inset and Closure | Flap inset and closure | Flap inset and closure |
Characteristic | Anterior-First Approach, n = 28 1 | Conventional Approach, n = 20 1 | p-Value 2 |
---|---|---|---|
Flap elevation (minutes) | 139 (129, 145) | 200 (165, 228) | <0.001 |
Anterior dissection | 33 (29, 37) | 0 (0, 0) | |
Lateral dissection | 104 (98, 116) | 200 (165, 228) | <0.001 |
Inset and closure (minutes) | 82 (71, 100) | 124 (100, 150) | <0.001 |
Total reconstruction time (minutes) | 228 (211, 243) | 330 (280, 377) | <0.001 |
Complication (%) | 0.14 | ||
Hematoma | 1 (3.6%) | 1 (5.0%) | |
Nipple color change | 0 (0%) | 1 (5.0%) | |
Seroma | 0 (0%) | 2 (10%) | |
Drain removal (days) | 7.0 (5.0, 12.2) | 8.0 (6.0, 10.0) | >0.9 |
Flap size (cm2) | 68 (51, 75) | 82 (77, 93) | 0.010 |
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Choi, J.; Ko, E.J.; Kim, S.A.; Choi, J.Y.; Moon, S.-H.; Jun, Y.J.; Byeon, J.H.; Oh, D.Y. Anterior-First Approach for Latissimus Dorsi Myocutaneous Flap Breast Reconstruction: A Refined Elevation Method with Detailed Video Instructions. J. Clin. Med. 2022, 11, 7387. https://doi.org/10.3390/jcm11247387
Choi J, Ko EJ, Kim SA, Choi JY, Moon S-H, Jun YJ, Byeon JH, Oh DY. Anterior-First Approach for Latissimus Dorsi Myocutaneous Flap Breast Reconstruction: A Refined Elevation Method with Detailed Video Instructions. Journal of Clinical Medicine. 2022; 11(24):7387. https://doi.org/10.3390/jcm11247387
Chicago/Turabian StyleChoi, Jangyoun, Eun Jeong Ko, Sung Ae Kim, Jong Yun Choi, Suk-Ho Moon, Young Joon Jun, Jun Hee Byeon, and Deuk Young Oh. 2022. "Anterior-First Approach for Latissimus Dorsi Myocutaneous Flap Breast Reconstruction: A Refined Elevation Method with Detailed Video Instructions" Journal of Clinical Medicine 11, no. 24: 7387. https://doi.org/10.3390/jcm11247387
APA StyleChoi, J., Ko, E. J., Kim, S. A., Choi, J. Y., Moon, S. -H., Jun, Y. J., Byeon, J. H., & Oh, D. Y. (2022). Anterior-First Approach for Latissimus Dorsi Myocutaneous Flap Breast Reconstruction: A Refined Elevation Method with Detailed Video Instructions. Journal of Clinical Medicine, 11(24), 7387. https://doi.org/10.3390/jcm11247387