A Retrospective Comparative Analysis of Latissimus Dorsi (LD) Flap Versus Thoracodorsal Artery Perforator (TDAP) Flap in Total Breast Reconstruction with Implants: A Pilot Study.


Journal

Journal of reconstructive microsurgery
ISSN: 1098-8947
Titre abrégé: J Reconstr Microsurg
Pays: United States
ID NLM: 8502670

Informations de publication

Date de publication:
Jul 2022
Historique:
pubmed: 8 9 2021
medline: 27 7 2022
entrez: 7 9 2021
Statut: ppublish

Résumé

 In breast surgery, an autologous flap combined with implant may reduce the risk or repair the soft-tissue defects in several cases. Traditionally, the preferred flap is the myocutaneous latissimus dorsi (LD) flap. In the perforator flap era, the evolution of LD flap is the thoracodorsal artery perforator (TDAP) flap. The aim of this study is the comparison between LD flap and TDAP flap with implants in terms of early complications and shoulder function.  We performed a retrospective cohort study in accordance with the STROBE guidelines. Between January 1 2015 and January 1 2020, 27 women underwent a unilateral total breast reconstruction with LD or TDAP flap combined with an implant at our institution. 15 women were operated with LD flap and 12 with TDAP flap. The most frequent indications for intervention were results of mastectomy and radiation-induced contracture. We evaluated several data in terms of clinical and demographical characteristics, operative and perioperative factors, and follow-up variables. We assessed shoulder function through the Disability of the Arm, Shoulder and Hand Questionnaire (DASH).  The rate of complications was significantly lower in the TDAP group compared with the LD group (16.7% vs 60.0%,  TDAP flap seems to be a reliable technique for soft-tissue coverage in total breast reconstruction with implants. In comparison with the traditional LD flap, it could be a more favorable option in terms of less complications and better quality of life.

Sections du résumé

BACKGROUND BACKGROUND
 In breast surgery, an autologous flap combined with implant may reduce the risk or repair the soft-tissue defects in several cases. Traditionally, the preferred flap is the myocutaneous latissimus dorsi (LD) flap. In the perforator flap era, the evolution of LD flap is the thoracodorsal artery perforator (TDAP) flap. The aim of this study is the comparison between LD flap and TDAP flap with implants in terms of early complications and shoulder function.
METHODS METHODS
 We performed a retrospective cohort study in accordance with the STROBE guidelines. Between January 1 2015 and January 1 2020, 27 women underwent a unilateral total breast reconstruction with LD or TDAP flap combined with an implant at our institution. 15 women were operated with LD flap and 12 with TDAP flap. The most frequent indications for intervention were results of mastectomy and radiation-induced contracture. We evaluated several data in terms of clinical and demographical characteristics, operative and perioperative factors, and follow-up variables. We assessed shoulder function through the Disability of the Arm, Shoulder and Hand Questionnaire (DASH).
RESULTS RESULTS
 The rate of complications was significantly lower in the TDAP group compared with the LD group (16.7% vs 60.0%,
CONCLUSIONS CONCLUSIONS
 TDAP flap seems to be a reliable technique for soft-tissue coverage in total breast reconstruction with implants. In comparison with the traditional LD flap, it could be a more favorable option in terms of less complications and better quality of life.

Identifiants

pubmed: 34492716
doi: 10.1055/s-0041-1735508
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

451-459

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Leonardo Brambilla (L)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

P Parisi (P)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

A Gatto (A)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

D Codazzi (D)

Plastic Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.

N Baronetto (N)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

R Gilardi (R)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

R Giovanazzi (R)

Department of Oncologic Breast Surgery - Breast Unit, Ospedale San Gerardo - ASST Monza, Monza, Italy.

A Marchesi (A)

Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo - ASST Monza, Monza, Italy.

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