Two-stage prosthetic breast reconstruction with latissimus flap: Prepectoral versus subpectoral approach.
J Plast Reconstr Aesthet Surg
; 73(3): 501-506, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31810892
ABSTRACT
BACKGROUND:
Use of latissimus flap in prosthetic breast reconstruction after mastectomy is an established approach, particularly in patients who have failed breast-conserving therapy. This study presents a comparison of the prepectoral and the subpectoral approach for two-stage prosthetic breast reconstruction with a latissimus flap.METHODS:
A retrospective review of outcomes and complications was completed between the prepectoral group (nâ¯=â¯33 patients, 50 reconstructed breasts) and the subpectoral group (nâ¯=â¯22 patients, 36 reconstructed breasts).RESULTS:
The demographics were similar between the prepectoral and subpectoral groups in terms of mean age (52.4â¯vs. 52.5 years, pâ¯=â¯0.97), smoking history (15.1% vs. 13.6%; pâ¯=â¯1.00), radiation history (75.8% vs. 91.0%; pâ¯=â¯0.28), and mean length of follow-up (479â¯vs. 680 days; pâ¯=â¯0.07). The body mass index was significantly higher in the prepectoral group (27.6â¯vs. 25.2â¯kg/m2; pâ¯=â¯0.03). Complications were similar between the groups in terms of hematoma (9.1% vs. 0.0%, pâ¯=â¯0.26), infection resulting in implant failure (9.1% vs. 4.5%, pâ¯=â¯0.64), thromboembolic events (3.0% vs. 4.5%, pâ¯=â¯1.0), donor site seroma (66.7% vs. 40.9%, pâ¯=â¯0.09), breast seroma (18.2% vs. 27.3%, pâ¯=â¯0.51), capsular contracture (9.1% vs. 4.5%, pâ¯=â¯0.64), animation deformity (39.4% vs. 50.0%, pâ¯=â¯0.58), and reoperation (24.2% vs. 22.8%, pâ¯=â¯1.00). Patient satisfaction scores were also similar between the groups (4.33⯱â¯1.08â¯vs. 4.14⯱â¯1.13, pâ¯=â¯0.52).CONCLUSIONS:
The prepectoral approach for two-stage immediate prosthetic reconstruction with a latissimus flap has similar outcomes and complications to those of the subpectoral approach, yet obviating the need for any pectoralis major muscle dissection.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Retalhos Cirúrgicos
/
Mamoplastia
/
Músculos Superficiais do Dorso
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article