Uso do retalho miogorduroso segmentar do músculo latíssimo do dorso em decúbito único para reconstrução da mama pós-quadrantectomia externa

Abstract

Rev. Bras. Cir. Plást. 2011; 26(4): 649-54 649Use of latissimus dorsi muscle segment with muscle and fat components in single decubitus position for breast reconstruction after quadrantectomy Use of latissimus dorsi muscle segment with muscle and fat components in single decubitus position for breast reconstruction after quadrantectomy Uso do retalho miogorduroso segmentar do músculo latíssimo do dorso em decúbito único para reconstrução da mama pós-quadrantectomia externa ABSTRACT Background: Nowadays, more and more immediate breast reconstructions are carried out after cancer treatment. For performing radical mastectomy, there are several recognized techniques. In quadrantectomy, the options for defect repair range from primary closure to the use of oncoplastic surgery techniques. In the case of external quadrant tumors, there is no option of rotation of the entire latissimus dorsi muscle, which usually exceeds the actions necessary for repairing lost volume. A new option for post-quadrantectomy reconstruction in external quadrants is proposed in this study. Methods: The surgical technique consists of dissection of the lateral segment of the latissimus dorsi muscle by an extension of the incision for lesion removal in the same supine position, followed by rotation and modeling of this segment to repair the defect caused by cancer removal. Twenty-one women aged 33 to 69 years underwent quadrantectomies of external quadrants followed by reconstruction with the technique described in this paper. To evaluate the method, each result had a score attributed to volume, shape, symmetry, and changes in the nipple areolar complex, as well as scar and operated quadrant surface. Results: The obtained results of volume and shape were superior in relation to those of symmetry. The average grade was 7.048, equivalent to B concept. Conclusions: The new technique decreased surgical time. The acquisition of the B concept demonstrates the method's feasibility. Keywords:Breast neoplasms/surgery. Mammaplasty. Plastic surgery/methods. RESUMOIntrodução: Cada vez mais são realizadas reconstruções imediatas da mama pós-tratamento do câncer. Para as mastectomias radicais, há várias técnicas consagradas. Na quadrantectomia, as opções de reparação do defeito vão do fechamento primário à utilização de técnicas de cirurgia oncoplástica. Para os tumores dos quadrantes externos, a opção de rotação de todo o músculo latíssimo do dorso é desnecessária, uma vez que usualmente excede ao necessário à reparação do volume perdido. Neste trabalho é proposta uma nova opção para a reconstrução pós-quadrantectomia em quadrantes externos. Método: A técnica cirúrgica consiste na dissecção do segmento lateral do músculo latíssimo do dorso pelo prolongamento da incisão Study conducted at the