Pedicled Descending Branch Latissimus Dorsi Mini-Flap For Breast Reconstruction: Shoulder Functional and Aesthetic Outcomes.

Background: The cosmetic drawbacks of BCT are asymmetry, nipple or skin retraction, and volume loss which results in an unsatisfactory cosmetic outcome. Therefore, many volume replacement techniques were invented to counteract this. The commonest volume replacement technique for breast reconstruction is autologous LD flap in which skin paddle and subcutaneous tissue are harvested with the flap resulting in increased donor site morbidity. Objective: To evaluate the latissimus dorsi mini-flap (LDMF) regarding the cosmetic outcomes and patient satisfaction. Moreover, it will evaluate procedure related complications and the benefit of using this procedure as a volume replacement to large breast defect after wide local excision in different breast quadrants excluding the lower inner quadrant (LIQ). Patients and Methods: Our study was conducted on 15 patients to evaluate post-operative complications and patient satisfaction primarily. The results have demonstrated the safety of this procedure which is associated with a low rate of complications. Our study was designed to assess breast-sparing approaches using LD mini flap (LDMF) for reconstruction of the breast after wide local excision of large breast tumors that would result in otherwise unacceptable deformity. Results: The LDMF generally is not a time-consuming technique as the average operative time was generally less than three hours. This time included the time for resection and the time waiting for frozen section results. The LDMF reconstruction was associated with considerable sensory preservation. This technique not only preserves most of the breast tissue but also, it spares us doing additional procedures such as nipple reconstruction. Avoidance the use of an implant is an additional advantage to the LDMF as this decrease the rate of infection and decrease the cost of the procedure. Conclusion: LDMF volume replacement extends the role of breast-conserving surgery to a group of patients who are traditionally offered mastectomy. Despite the increasing use of Neoadjuvant chemotherapy, some patients have a disease that fails to respond or extensive DCIS and can, therefore, benefit from this oncoplastic technique. Frozen-section analysis of the tumor cavity is essential for surgical decision making. Our study had demonstrated the safety of this procedure which is associated with a low rate of complications. This technique has a high patient satisfaction rate wit agreeable cosmetic outcome. This technique can be used as a volume replacement to large breast defect in different breast quadrant except in lower inner quadrant which was not included in this study. [ABSTRACT FROM AUTHOR]

Copyright of QJM: An International Journal of Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)