Oncoplastic surgery with omental flap reconstruction: a study of 200 cases

Zaha, Hisamitsu; Abe, Norie; Sagawa, Noriko; Unesoko, Mikiko

doi:10.1007/s10549-017-4124-9

Cited by 42 publications

(55 citation statements)

References 18 publications

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“…Initially, laparotomy was almost the only technique used. Successively, laparoscopy was more often performed for breast reconstruction in patients with early-stage breast cancer [7][8][9] and also for additional coverage of breast implants [10]. Interestingly, Claro et al reported that flap necrosis is the most frequent complication (31.87%), with the second most common complication being breast infection (19.05%), followed by abdominal wall hernia (16.12%) and bowel obstruction or ileus (9.16%).…”

Section: Discussionmentioning

confidence: 99%

Breast reconstruction with the omentum flap: a case report with unsatisfactory outcome and review of the literature

et al. 2019

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Background Recently, breast reconstruction with the greater omentum flap has gained more attention, although it has been only rarely reported in the literature. An unpleasant case presented by us here prompted us to perform a literature search on breast reconstruction with the omentum flap concerning postoperative results and complication rates. Case presentation We here present the case of a 46year-old woman who presented with severe infection 3 months after omentum flap reconstruction in a distant local hospital. Intraoperative revision showed an inflammatory, completely necrotic flap that had to be removed. Conclusion The literature review shows that the omentum flap can be reasonably used only in onesided reconstructions of very small breasts. Due to the limited indications, unpredictable flap volume, and our negative experience, we recommend that this type of reconstruction be used with restraint.

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Section: Discussionmentioning

confidence: 99%

Breast reconstruction with the omentum flap: a case report with unsatisfactory outcome and review of the literature

et al. 2019

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“…Some reports have found that omental flap procedures are limited by possible volume insufficiency during reconstruction, which is difficult to predict preoperatively. [1][2][3]9,10 In this study, we were able to harvest as much omental tissue by meticulously dissecting the fused omentum around the hepatic flexure or the root of the right gastroepiploic pedicle and isolating the infrapyloric vessels as we would have had we used the same method employed in pylorus-preserving gastrectomy. 11,12 In conclusion, ICG-enhanced NIR imaging is a feasible and useful tool in terms of vascular perfusion for laparoscopically harvesting an omental flap in breast cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…When immediate breast reconstruction using omental flaps was initially introduced, it was not actively performed because it required a laparotomy that left a large abdominal scar. However, recent advances in minimally invasive surgery have enabled surgeons to obtain an omental flap laparoscopically with less donor‐site deformity . Successful breast reconstruction using autologous tissue depends on flap viability.…”

Section: Introductionmentioning

confidence: 92%

“…However, recent advances in minimally invasive surgery have enabled surgeons to obtain an omental flap laparoscopically with less donor-site deformity. [1][2][3] Successful breast reconstruction using autologous tissue depends on flap viability. Previous reports have lacked intraoperative scientific assessment of flap viability and experiences regarding a wide omental flap after mastectomy.…”

Section: Introductionmentioning

confidence: 99%

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Near‐infrared image‐guided laparoscopic omental flap for breast cancer

Park

Suh

Park

et al. 2019

Asian J Endoscop Surgery

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Background Near‐infrared (NIR) imaging with indocyanine green (ICG)‐enhanced fluorescence is widely used in laparoscopic surgery. This study aimed to evaluate this technique's feasibility and usefulness in intraoperatively assessing vascular perfusion in a laparoscopically harvested omental flap. Materials and Surgical Techniques From March 2015 to February 2016, we prospectively evaluated patients undergoing breast cancer surgery followed by immediate breast reconstruction using a laparoscopically harvested omental flap. After laparoscopic preparation of the pedicled graft, the perfusion area of the omental graft was evaluated by using intraoperative Doppler ultrasonography and NIR imaging with intravenous ICG injection. Graft viability was evaluated by using Doppler ultrasonography 2 days postoperatively; for cosmetic outcome, Breast Cancer Conservative Treatment Cosmetic Results software was used 1 month postoperatively. Discussion The laparoscopic harvesting of an omental flap was successfully performed in eight patients without conversion to open surgery. The mean time to the initial detection of ICG‐enhanced fluorescence uptake was 3.25 ± 1.16 minutes. On intraoperative Doppler ultrasonography, a pulseless area ≥10% was detected in five patients (62.5%). However, NIR imaging revealed no patients had an ischemic portion ≥10%. There were no ICG‐related intraoperative or postoperative complications. All patients showed patent vessels on Doppler ultrasonography 2 days postoperatively. Cosmetic outcomes were mostly favorable 1 month postoperatively. The Breast Cancer Conservative Treatment Cosmetic Results evaluation 1 month postoperatively showed excellent, good, and fair results, with no poor scores. With regard to vascular perfusion, ICG‐enhanced NIR imaging is a feasible and useful tool for harvesting a laparoscopic omental flap in breast cancer patients.

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“…In the recent decades, the surgical management of breast cancer has steadily evolved from radical surgery to breast conservation. As a result, oncoplastic surgical techniques have emerged and are expanding dramatically . Oncoplastic surgery combines oncologic resection with immediate breast reconstruction using techniques derived from plastic surgery.…”

Section: Discussionmentioning

confidence: 99%