Abstract
Background
The extended latissimus dorsi (ELD) musculocutaneous flap is one of the surgical techniques used for breast reconstruction. Preoperative preparation to determine the exact amount of flap tissue to be harvested is important to achieve a good outcome with autologous tissue reconstruction. However, few reports exist on objective preoperative volume prediction of ELD flaps. The purpose of this study was to quantify the elevated ELD volume as a preoperative plan.
Methods
Patients who underwent immediate or delayed breast reconstruction with ELD flap after mastectomy between March 2015 and January 2022 are included. (1) The ELD flap was designed preoperatively, X-ray contrast thread was applied along the design, and CT imaging was performed in the same lateral supine position as the surgical position. 3D images were constructed, and the volume-rendering method was used to obtain the integrated volume. (2) Intraoperative ELD flap volume was calculated using the water displacement method. The correlation between (1) and (2) was examined.
Results
(1) The mean preoperative predicted value was 290.2 mL and (2) the mean intraoperative ELD flap volume was 298.3 mL. The correlation coefficient between the two volumes was 0.93, indicating that they were correlated.
Conclusion
We could quantify the ELD flap volume using the volume-rendering method with X-ray contrast threads. This study could be a useful method for preoperative prediction planning of the ELD flap in breast reconstruction.
Level of Evidence IV
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Acknowledgements
This work was supported in part by research support from the Center for Diversity at Tokyo Medical University (TMUCD-202212).
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This study was reviewed and approved by the Institutional Review Board of the Tokyo Medical University, and informed consent was obtained from all subjects. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Komiya, T., Kaise, H., Ojima, Y. et al. Volume Prediction of Extended Latissimus Dorsi Musculocutaneous Flap for Breast Reconstruction Using a Computed Tomography Volume-Rendering Technique with an X-ray Contrast Thread Marking. Aesth Plast Surg 47, 1335–1342 (2023). https://doi.org/10.1007/s00266-023-03255-9
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DOI: https://doi.org/10.1007/s00266-023-03255-9