Endoscopic Latissimus Dorsi Muscle Flap for Breast Reconstruction After Skin-Sparing Total Mastectomy: Report of 14 Cases

Iglesias, Martin; Gonzalez-Chapa, Diego R.

doi:10.1007/s00266-013-0131-3

Cited by 25 publications

(40 citation statements)

References 20 publications

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“…Endoscopic non-robotic LDFR was reported in several studies [4][5][6][7][8], and in 2007, Missana et al reported a study including 52 patients [4] and more recently by others with smaller series [6][7][8]. Nakajima et al [8] reported a study with 168 LDF video-assisted reconstructions but only for reconstruction after partial mastectomy.…”

Section: Discussionmentioning

confidence: 99%

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Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

et al. 2019

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Background: Robotic latissimus dorsi-flap reconstruction (RLDFR) after skin-sparing mastectomy (SSM) for breast cancer (BC) has been performed through a single nipple incision. We report results of SSM with RLDFR, mainly with analysis of feasibility, morbidity, indications, and technique standardization. Methods: We determined characteristics of patients, previous treatment of BC, and type of reconstruction. Surgical technique, duration of surgery, and complication rate were reported according to three successive periods: P1-3. Results: Forty RLDFR, with breast implant for 16 patients, with previous breast radiotherapy in 30% had been performed. In logistic regression, factors significantly associated with duration of surgery ≥ 300 min were P2 (OR 0.024, p = 0.004) and P3 (OR 0.012, p = 0.004) versus P1. The median mastectomy weight was 330 g and 460 g for BMI < and ≥ 23.5 (p = 0.025). Length of hospitalization was 4 days. Total complication rate was 20% (8/40): seven breast complications (four re-operations) and one RLDF complication with re-operation. Periods were significantly predictive of complications (p = 0.045). Conclusion: SSM with RLDFR is feasible, safe, and reproducible. We reported a decrease of duration of surgery, length of post-operative hospitalization, and complication rate.

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Section: Discussionmentioning

confidence: 99%

“…Development of robotic surgery since several years was very important for prostatic cancer, gynecologic cancer, colo-rectal cancer, and thoracic and thyroid surgery [1][2][3]. Endoscopic non-robotic latissimus dorsi-flap breast reconstruction (LDFR) has been reported in several studies [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

et al. 2019

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“…Thus, these findings were consistent with the results from previous studies evaluating satisfaction. 8,16,17,[27][28][29] According to some authors, mastectomy can cause low self-esteem and body image issues. Therefore, reconstruction is indicated for patients requiring mastectomy.…”

Section: Discussionmentioning

confidence: 99%

Patient satisfaction with breast reconstructionusing musculocutaneous flap from latissimus dorsiversus from rectus abdominis: a cross-sectional study

et al. 2018

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Breast cancer is the second most frequent type of cancer in the world and the most common type among women. Overall, it accounts for 28% of new cases of cancer. 1 In developed countries, the five-year survival rate is about 85%, whereas in developing countries, it remains between 50 and 60%. 1 It has been estimated that there will be 59,700 new cases of breast cancer in Brazil in 2018, i.e. 56.33 cases per 100,000 women. 1 Therapeutic and technological advances relating to breast cancer have allowed patients to attain greater life spans, and this has drawn attention to the quality of life of these women. 2-4 Mastectomy is considered to be one of the most devastating types of cancer treatment from a psychological point of view, in that it affects the self-esteem, femininity and body image of these patients. 5,6 However, breast reconstruction can be undertaken immediately after mastectomy or as a delayed procedure. Breast reconstruction procedures have positive impacts on all aspects of quality of life, including body image, particularly among younger women. 2,7 There are several types of breast reconstruction. The autologous reconstruction methods that are most used are breast reconstruction using a transverse rectus abdominis musculocutaneous flap and breast reconstruction using a latissimus dorsi flap, which provide safety and satisfaction for patients and improve their quality of life. 2,8,9,10 Anderson et al. developed a specific questionnaire for patients with breast diseases (named the Breast Evaluation Questionnaire) that has proven to be reliable and valid. It contains 55 questions and was developed to assess patients' satisfaction with their breasts and their contentment

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“…The traditional open technique requires a 15 to 30 cm dorsal incision. Endoscopic LDF has been proposed and achieved in some centers, 18-27 but this surgical procedure is not easy with nonflexible endoscopic instruments and a 2-dimensional view.…”

Section: Introductionmentioning

confidence: 99%

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With Robotic Latissimus Dorsi Flap Harvest: Technique and Results

et al. 2020

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Introduction. Only few cases of robotic latissimus dorsi flap reconstruction (RLDFR) have been reported in indication of reconstruction for breast cancer (BC). We report our experience of combined robotic nipple-sparing mastectomy (R-NSM) and RLDFR, and analyze technique, indications, and reproducibility. Methods. All patients with R-NSM and RLDFR from November 2016 to August 2, 2018, were analyzed, and technics have been described. Complication rate with Clavien-Dindo grading and postoperative hospitalization length (days) are reported. Results. Thirty-five R-NSM with RLDFR were performed in 22 cases for primitive BC and 13 for local recurrence. In 12 patients, another surgical procedure was performed during the same time (axillary lymph node dissection or contralateral breast surgery). R-NSM was realized through a short axillar incision, with inside-only installation for 12 patients (34.3%): 18 nonautologous and 17 autologous RLDFR associated with implant in 9 patients. In logistic regression, mastectomy weight >330 g was significantly associated with the use of implant (odds ratio [OR] = 17, P = .015), and significant factor of the time of anesthesia ≥380 minutes was 2 installations (OR = 10.4, P = .049). The median duration of hospitalization stay was 4 days. Complications rates were 51.4% (18/35; 9 grade-1, 2 grade-2, and 7 grade-3). In logistic regression, associated other surgical procedure was predictive of grade-3 complications (OR = 6.87, P = .053). Conclusion. We confirmed the reproducibility and safety of R-NSM and RLDFR with a decreased complication rate. NSM was performed in 42.8% of our patients after previous radiotherapy. We observed an increase of grade-3 complications when R-NSM and RLDFR was combined to another surgical procedure.

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Endoscopic Latissimus Dorsi Muscle Flap for Breast Reconstruction After Skin-Sparing Total Mastectomy: Report of 14 Cases

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 25 publications

References 20 publications

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

Patient satisfaction with breast reconstructionusing musculocutaneous flap from latissimus dorsiversus from rectus abdominis: a cross-sectional study

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With Robotic Latissimus Dorsi Flap Harvest: Technique and Results

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