Comparing the thoracodorsal and internal mammary vessels as recipients for microsurgical autologous breast reconstruction: A systematic review and meta‐analysis

Samargandi, Osama A.; Winter, Jessica; Corkum, Joseph P.; Youha, Sarah Al; Frank, Simon G.; Williams, Jason

doi:10.1002/micr.30244

Cited by 11 publications

(14 citation statements)

References 37 publications

(69 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Venous second largest branch to the latissimus dorsi muscle showed a 42.7% diametric difference, but it was involved in 14.6% of anastomosis cases. The frequency of anastomosis with the largest branch to the latissimus dorsi muscle and the second largest branch to the latissimus dorsi muscle was 38% because it is more advantageous to connect a larger donor pedicle to a smaller recipient vessel [24].…”

Section: Discussionmentioning

confidence: 99%

“…The TD vessels are commonly used recipients for immediate breast reconstructions because they are obtainable after axillary dissection during mastectomy [18]. Although IM vessels have been applied more frequently in recent years, the results of a meta-analysis show that both the IM and TD vessels are safe as recipients without no significant difference in rates of flap failure or other complications [24]. The TD artery is the smaller recipient [17], so it has a more favorable diameter for microsurgical anastomoses.…”

Section: Discussionmentioning

confidence: 99%

“…Size discrepancy can cause turbulent flow into the flap and is consequently a major risk factor for subsequent thrombotic complications [ 8 – 10 ]. This problem may be pronounced when blood flows from a smaller donor vessel to a larger recipient [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction

Kim

Moon

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

Background. In microvascular anastomosis, size discrepancy is common and can increase thrombotic complications. If size differences can be predicted, then vessels of the appropriate size can be selected. This study documented the difference in diameter between the thoracodorsal (TD) vessel and deep inferior epigastric perforator (DIEP) pedicle in each patient who underwent breast reconstruction using free tissue transfer. Patients and Methods. This retrospective study included 32 anastomoses (27 breasts including five cases of supercharged anastomosis) of breast reconstruction with the free DIEP flap and TD recipient between August 2018 and June 2019. In the microscopic view, the caliber of the TD vessel, the largest branch to the serratus anterior muscle, the descending branch, the largest and the second largest branches to the latissimus dorsi muscle, and the DIEP pedicle were measured. Results. The diameter of the deep inferior epigastric artery was similar to that of the descending branch, and their anastomosing rate was 56.3%. The diameter of the deep inferior epigastric vein was similar to the branch to the serratus anterior muscle and the descending branch, and their anastomosing rates were 29.3% and 29.3%, respectively. All flaps were survived; however, in one case, a reoperation was needed to remove the hematoma, in which case fat necrosis occurred as the only complication. Conclusion. TD branches of similar size to the DIEP pedicle were prioritized in anastomosis. The descending branch and the branch to the serratus anterior muscle are expected to be good candidates as recipients in breast reconstruction with DIEP free flap. Moreover, supercharged anastomosis of DIEP pedicles can be achieved within TD branches.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction

Kim

Moon

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…However, the use of thoracodorsal vessels sacrifices a common salvage option for breast reconstruction (Moran, Nava, Behnam, & Serletti, ), but if the serratus branch of the thoracodorsal vessels or proximal segment of the serratus branch of thoracodorsal vessel is selected, latissimus dorsi flap‐based breast reconstruction can still be performed when revision is required. Moreover, the risk of arm lymphedema (Samargandi et al, ) and nerve injury can be minimized using the serratus branch of the thoracodorsal vessel because the serratus branch is located far from the origin of the thoracodorsal artery and nerve. The nerve is quite definite and large enough to be easily preserved during recipient dissection.…”

Section: Discussionmentioning

confidence: 99%

Superficial inferior epigastric artery‐supercharged deep inferior epigastric artery perforator flap‐based breast reconstruction for a thin patient: A case report

et al. 2019

View full text Add to dashboard Cite

Although a bipedicled deep inferior epigastric artery perforator (DIEP) flap is widely accepted for slim patients with large breasts, we suggest DIEP flap-based breast reconstruction in which the superficial inferior epigastric artery (SIEA) is supercharged to the branch of thoracodorsal vessel as an alternative, which has not previously been well described. We report the case of a 48-year-old breast cancer patient who had a normal body mass index of 23.01 and relatively thin abdominal tissue, with large and ptotic (grade II ptosis) breasts. The mastectomy specimen weighed~890 g, and the harvested abdominal tissue weighed~700 g with a size of 32 × 12 cm 2 . The elliptical-shaped flap was inset with a 90 counterclockwise rota-

show abstract

“…The internal mammary vessels at our institution are preferred because the thoracodorsal vessels can be damaged during the mastectomy or lymph node dissection and require a long pedicle to allow for medialization of the flap. Some prefer the thoracodorsal vessels because of easier dissection but either recipient vessel has the same outcomes and are proven to be safe and reliable [20]. To expose the internal mammary vessels, the mastectomy skin is gently retracted and then the pectoralis major muscle is split over the third costal cartilage.…”

Section: Recipient Vessel Harvestmentioning

confidence: 99%

Immediate Breast Reconstruction with Free Autologous Tissue Transfer

Zelones¹,

Inchauste²,

Nguyen³

2020

Breast Cancer and Breast Reconstruction

View full text Add to dashboard Cite

Immediate breast reconstruction in the United States is increasing with the majority of patients undergoing implant-based reconstruction. The use of pedicled autologous tissues has also been used, but due to significant donor site morbidity, free autologous tissue transfer has largely replaced it. The gold standard currently for breast reconstruction is free autologous tissue transfer from the abdomen if no contraindications exist. However, not all hospitals have the expertise available to perform free autologous tissue transfers for breast reconstruction. Other donor sites available for free autologous tissue transfer include the thigh and gluteal areas. With advances in free tissue transfer techniques, the donor site morbidity and flap failure rates are minimal. The ultimate goal for any breast reconstruction patient is to achieve the appropriate size, shape, symmetry, softness, and sensation. The goal of this chapter is to assist in achieving these goals in the immediate breast reconstruction patient through the use of free autologous tissue transfers.

show abstract

Comparing the thoracodorsal and internal mammary vessels as recipients for microsurgical autologous breast reconstruction: A systematic review and meta‐analysis

Abstract: Therapeutic, Level of evidence: III.

Cited by 11 publications

References 37 publications

Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction

Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction

Superficial inferior epigastric artery‐supercharged deep inferior epigastric artery perforator flap‐based breast reconstruction for a thin patient: A case report

Immediate Breast Reconstruction with Free Autologous Tissue Transfer

Contact Info

Product

Resources

About