Latissimus dorsi breast reconstruction with or without implants: A comparison between outcome and patient satisfaction.


Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 12 10 2017
revised: 15 07 2018
accepted: 28 10 2018
pubmed: 15 1 2019
medline: 25 12 2019
entrez: 15 1 2019
Statut: ppublish

Résumé

The latissimus dorsi (LD) flap is largely used in breast reconstruction. The aim of this study is to evaluate and compare the advantage of the LD flap in association with an implant to that of LD flap in association with lipofilling to add additional volume following breast reconstruction by assessing the number of revision procedures, length of hospitalization, complication rate, and patient satisfaction. A retrospective cohort study was performed to evaluate complication rate, number and type of revision procedures required, hospitalization time, and overall duration of the reconstructive process in patients undergoing LD breast reconstruction in our department between January 2012 and March 2015. Patient satisfaction was assessed using BREAST-Q®. Ninety-five breast reconstructions performed on 90 patients were included. In 38 patients, 42 breasts were reconstructed using LD flap in association with lipofilling (Group 1). In the remaining 52 patients, 53 breast reconstructions were performed using LD flap in association with an implant (Group 2). Findings concerning total hospitalization time, overall duration of the reconstructive process, and the distribution of supplementary surgical procedures demonstrated no statistically significant differences between the two groups. However, the surgical complication rate was higher in Group 2 than in Group 1 (14.2% vs. 18.8%, respectively). Regarding BREAST-Q, a detailed analysis of the "satisfaction with breasts" domain showed a higher score for Group 1 than for Group 2. The association of a breast implant with LD reconstruction does not decrease breast reconstruction time in terms of the number of revision procedures and hospitalization time, exposes patients to a higher complication rate, and does not improve patient satisfaction.

Sections du résumé

BACKGROUND BACKGROUND
The latissimus dorsi (LD) flap is largely used in breast reconstruction. The aim of this study is to evaluate and compare the advantage of the LD flap in association with an implant to that of LD flap in association with lipofilling to add additional volume following breast reconstruction by assessing the number of revision procedures, length of hospitalization, complication rate, and patient satisfaction.
METHODS METHODS
A retrospective cohort study was performed to evaluate complication rate, number and type of revision procedures required, hospitalization time, and overall duration of the reconstructive process in patients undergoing LD breast reconstruction in our department between January 2012 and March 2015. Patient satisfaction was assessed using BREAST-Q®.
RESULTS RESULTS
Ninety-five breast reconstructions performed on 90 patients were included. In 38 patients, 42 breasts were reconstructed using LD flap in association with lipofilling (Group 1). In the remaining 52 patients, 53 breast reconstructions were performed using LD flap in association with an implant (Group 2). Findings concerning total hospitalization time, overall duration of the reconstructive process, and the distribution of supplementary surgical procedures demonstrated no statistically significant differences between the two groups. However, the surgical complication rate was higher in Group 2 than in Group 1 (14.2% vs. 18.8%, respectively). Regarding BREAST-Q, a detailed analysis of the "satisfaction with breasts" domain showed a higher score for Group 1 than for Group 2.
CONCLUSIONS CONCLUSIONS
The association of a breast implant with LD reconstruction does not decrease breast reconstruction time in terms of the number of revision procedures and hospitalization time, exposes patients to a higher complication rate, and does not improve patient satisfaction.

Identifiants

pubmed: 30639156
pii: S1748-6815(18)30355-3
doi: 10.1016/j.bjps.2018.10.003
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

381-393

Informations de copyright

Copyright © 2018 Elsevier Ltd. All rights reserved.

Auteurs

S Leuzzi (S)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France; Department of Plastic, Reconstructive and Aesthetic Surgery Ospedali Riuniti, Trieste, Italy.

A Stivala (A)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France; Department of Plastic, Reconstructive and Aesthetic Surgery Centre Hospitalier Universitaire, Dijon, France. Electronic address: alessiostivala87@gmail.com.

J B Shaff (JB)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France.

A Maroccia (A)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France.

J Rausky (J)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France.

M Revol (M)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France.

Baptiste Bertrand (B)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital la Conception, Marseille, France.

S Cristofari (S)

Department of Plastic, Reconstructive and Aesthetic Surgery Hospital Tenon, Paris, France.

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