The traditional versus endoscopic-assisted latissimus dorsi harvest in oncoplastic surgery: A long term comparison of breast volume, aesthetics, and donor site outcomes.

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  • Author(s): Chang HP;Chang HP; Fan KL; Fan KL; Song SY; Song SY; Lee DW; Lee DW
  • Source:
    Asian journal of surgery [Asian J Surg] 2020 Dec; Vol. 43 (12), pp. 1165-1171. Date of Electronic Publication: 2020 Mar 17.
  • Publication Type:
    Comparative Study; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8900600 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0219-3108 (Electronic) Linking ISSN: 10159584 NLM ISO Abbreviation: Asian J Surg Subsets: MEDLINE
    • Publication Information:
      Publication: [Amsterdam] : Elsevier
      Original Publication: [Hong Kong] : The Association, [1988-
    • Subject Terms:
      Esthetics*; Breast Neoplasms/*psychology ; Breast Neoplasms/*surgery ; Cicatrix/*psychology ; Endoscopy/*methods ; Mammaplasty/*methods ; Mastectomy/*methods ; Mastectomy, Segmental/*methods ; Superficial Back Muscles/*surgery ; Superficial Back Muscles/*transplantation ; Tissue and Organ Harvesting/*methods; Adult ; Aged ; Female ; Humans ; Middle Aged ; Surgical Flaps ; Time Factors ; Treatment Outcome
    • Abstract:
      Background/objective: Volume replacement with the latissimus dorsi (LD) is an option for patients after partial mastectomy. Although potential benefits of using the endoscopic technique have been previously described, previous studies have not assessed long term volume and aesthetic outcomes compared to traditional methods. In this study, we aim to compare the endoscopic, latissimus only harvest to the traditional latissimus with skin paddle method.
      Methods: Eleven patients underwent breast reconstruction with the traditional LD flap harvesting method; 9 underwent endoscopically assisted LD flap reconstruction. The difference between preoperative and >1 year postoperative volumes were recorded. Patient satisfaction and surgeon-based observer assessment of the breast aesthetic and donor site scar were compared between the two techniques.
      Results: Compared to the traditional group, there was a significant mean volume reduction in the endoscopic group (70.3 vs 21.7 cc, p = 0.0023). Operative time was also longer in the endoscopic group than in the traditional group (368 vs 257 min, p < 0.001). In observer assessment criteria, the result of the donor site scar assessment was superior in the endoscopic group in terms of vascularity (p = 0.0038), relief (p = 0.0023), and pliability (p = 0.053).
      Conclusion: Patients' attitudes and feelings about the scar were better in the endoscopic group than in the traditional group. However, compared to the endoscopic group, the traditional group achieved a better breast cosmetic result and better retention of volume postoperatively, possibly due to incorporation of the skin flap and adipo-fascial tissue.
      Competing Interests: Declaration of competing interest None declared.
      (Copyright © 2020. Published by Elsevier Taiwan LLC.)
    • Contributed Indexing:
      Keywords: Breast; Endoscopes; Scar
    • Publication Date:
      Date Created: 20200321 Date Completed: 20210115 Latest Revision: 20210115
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.asjsur.2020.03.002
    • Accession Number:
      32192908