Immediate breast reconstruction with laparoscopically harvested omental flap: A retrospective analysis with a maximum 12-year follow-up.

PURPOSE: To evaluate the clinical efficacy of immediate breast reconstruction with free or pedicled laparoscopically harvested omental flaps (LHOFs). METHODS: Between March 2011 and 2021, 82 patients who underwent immediate breast reconstruction with free or pediculated omental flaps were enrolled. Breast total or partial mastectomy, laparoscopic greater omentum harvest, and breast reconstruction were carried out in an orderly manner. Postoperative operative results, cosmetic outcomes, and complications were investigated. RESULTS: Seventeen cases of free LHOF and 65 cases of pedicled LHOF were performed. Cosmetic results were mostly satisfactory (61% excellent, 35% good), with a soft breast that was natural in appearance. Satisfaction investigation showed that 96.2% of patients were satisfied with the reconstructed breast. Uneventful follow-up showed no abdominal complications at the donor site, and the surface skin displayed no swelling. No major complications were found, except for three cases of necrosis. One patient developed slight hematoma. Two patients were found to have local recurrence, and one had distant metastasis. Twenty-four patients accepted radiotherapy, but no size reduction was noted after radiotherapy. We followed the patients to determine their survival status. All patients were alive, except for 1 in the free LHOF group who died 31.2 months after surgery. CONCLUSION: Immediate breast reconstruction with LHOF provides a soft reconstructed breast with relatively little donor-site deformity and is useful for breast tumor-specific immediate reconstruction.

Emerging potential of ubiquitin-specific proteases and ubiquitin-specific proteases inhibitors in breast cancer treatment.

Breast cancer is the most frequently diagnosed cancer in women, accounting for 30% of new diagnosing female cancers. Emerging evidence suggests that ubiquitin and ubiquitination played a role in a number of breast cancer etiology and progression processes. As the primary deubiquitinases in the family, ubiquitin-specific peptidases (USPs) are thought to represent potential therapeutic targets. The role of ubiquitin and ubiquitination in breast cancer, as well as the classification and involvement of USPs are discussed in this review, such as USP1, USP4, USP7, USP9X, USP14, USP18, USP20, USP22, USP25, USP37, and USP39. The reported USPs inhibitors investigated in breast cancer were also summarized, along with the signaling pathways involved in the investigation and its study phase. Despite no USP inhibitor has yet been approved for clinical use, the biological efficacy indicated their potential in breast cancer treatment. With the improvements in phenotypic discovery, we will know more about USPs and USPs inhibitors, developing more potent and selective clinical candidates for breast cancer.

Verification of Volume Similarity Between Unilateral Mammary Gland and Autologous Omentum in Adult Women by Measuring Cylinder Method.

OBJECTIVE: To verify the volume similarity between unilateral mammary gland and autologous omentum in adult females. METHODS: A total of 63 patients diagnosed with stage 0-II breast cancer and partial non-lactating multi-fistula mastitis in the breast surgery department of Inner Mongolia Xing'an League People's Hospital from 2007 to 2020 were enrolled in the study, including 52 cases of stage 0-II breast cancer and 11 cases of non-lactating multi-fistula mastitis. The volume of the resected mammary gland and the omentum were measured by a "soft tissue measuring cylinder" and recorded. The appearance of the reconstructed breast was compared with that of the healthy side. The correlation between unilateral mammary gland volume and autologous omentum volume was analyzed by linear regression. RESULTS: Valid data were obtained for 60 cases. Affected breast size, curve, texture, nipple, and inframammary fold after omentum breast reconstruction were similar and symmetrical to those of the unaffected side. Postoperative complications occurred in most patients; the majority of these (76.67%) involved numbness of the nipple, and other complications were few. Patient satisfaction with postoperative appearance, feel, and movement of the breast, as well as total treatment costs, was over 75.0%. Linear regression analysis indicates a linear relationship between subcutaneous gland volume (x) and autologous omentum volume (y): y = 0.9847x - 1.2132, R 2 = 0.9742. CONCLUSION: Only when the dissociated pedicled omentum is completely obtained under laparoscopy can the whole subcutaneous residual cavity of the mammary gland be filled to the same volume. This study verifies that the volume of the unilateral mammary gland is similar to that of the autologous omentum in adult females.

Application value of laparoscopy in radical mastectomy and omental breast reconstruction.

Application value of laparoscopy in radical mastectomy and omental breast reconstruction was explored. The medical records of 104 patients undergoing radical mastectomy and omental breast reconstruction from July 2015 to August 2017 in Inner Mongolia Xing'an League People's Hospital were retrospectively analyzed. Fifty-three patients undergoing laparoscopic surgery were the experimental group and 51 patients undergoing open surgery were the control group. The surgery conditions, upper limb function, postoperative complications, volume similarity between unilateral subcutaneous glands and autologous omentum, cosmetic excellent rate and treatment satisfaction were observed. The surgical duration of the patients in the experimental group was significantly longer than that in the control group, but the intraoperative blood loss was less and hospital stay was significantly shorter than that in the control group (P<0.05). The improvement of upper limb function in the experimental group was significantly better than that in the control group (P<0.05). The cosmetic excellent rate in the experimental group was significantly higher than that in the control group (P<0.001). The incidence of postoperative complications in the experimental group was significantly less than that in the control group (P<0.001). The satisfaction degree of patients in the experimental group was significantly higher than that in the control group (P<0.001). Filling the autologous omentum while excising the unilateral mammary gland is an equivalent replacement, which can make the appearance of the breast on the operation side similar to that on the healthy side, thus improving the excellent rate of breast beauty and patient satisfaction.