COMBINED ENDOSCOPIC LATISSIMUS DORSI FLAP WITH FAT GRAFT VERSUS EXTENDED LATISSIMUS DORSI FLAP FOR BREAST RECONSTRUCTION | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 05 September 2022 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2022.153202.1198 | ||
| Authors | ||
| Yasmin Barakat* 1; Ahmed Mohamed Elbadawy1; Ahmed Mohamed Abdelsalam2; Dalia Galal Saleh1; Mohamed Samir Badawy1 | ||
| 1Plastic, Burn & Maxillofacial department, Faculty of Medicine, Ain shams university, Ramses street, Abbasia, Cairo, Egypt | ||
| 2Plastic, Burn, and Maxillofacial surgery, faculty of medicine, Ain shams university. Cairo, Egypt. | ||
| Abstract | ||
| Background: Various breast reconstruction techniques after mastectomy have been developed over the last few years based on the idea of volume replacement, either by autologous flaps, such as Latissimus dorsi (LD)flap or device-based techniques, such as implants. Combined Endoscopic LD flap with fat graft is an advanced technique that enhances the muscle volume and lower the postoperative complications. Aim of the study: Comparison between combined Endoscopic LD Flap with fat graft versus extended LD Flap for breast reconstruction in breast cancer patients regarding the aesthetic outcome, and patient satisfaction on long term results. patients and methods: There were 40 female patients with early invasive breast carcinoma, including stages I, II, and IIIA, in accordance with the American Joint Committee on Cancer (AJCC) staging system (1) in this comparative analysis. Twenty patients each performed skin sparing mastectomy and immediate reconstruction using the conventional extended (LD) flap technique and the endoscopic (LD) flap with fat graft technique. Volume differences between the two studied groups that were evaluated before the surgery and six months after surgery were noted. Additionally, the donor site scar and patient satisfaction with the reconstructed breast were compared. Results: When compared to the conventional group, there was a substantial average volume decrease of the reconstructed breast in the endoscopic group (38.1 versus 18.1 percent, p = 0.001). Despite the fact, the endoscopic group's operation took longer time than the conventional group's (203 vs 151 min, p = 0.017), which is considered a disadvantage, donor site scar and postoperative seroma was better in the endoscopic group. Conclusion: Endoscopic LD muscle flap with fat graft is better than Extended Latissimus dorsi muscle flap for breast reconstruction regarding overall patient satisfaction and post operative donor site complications. Therefore, endoscopic LD muscle flap with fat graft could represent an alternative technique to Extended LD muscle flap in cases of early invasive breast cancers, including stages I, II, and IIIA, as specified by American Joint Committee on Cancer (AJCC) staging system (1) | ||
| Keywords | ||
| Breast cancer; skin sparing mastectomy; reconstruction; Lattisimus Doris flap; fat graft | ||
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