Aesthetic Plastic Surgery

, Volume 37, Issue 6, pp 1140–1145 | Cite as

Evaluation of Pedicled Omental Flap Delivered through a Minilaparotomy for Immediate Breast Reconstruction in Obese Patients

Original Article Breast

Abstract

Background

Studies have shown the laparoscopically harvested omental flap to be a successful method for immediate breast reconstruction. However, data about its usefulness and safety in obese women are limited. This study examined the effectiveness and safety of a pedicled omental flap delivered via a minilaparotomy in women with a body mass index (BMI) higher than 30 kg/m2.

Methods

Women candidates for skin-sparing mastectomy underwent reconstruction with delivery of a pedicled omental flap via a minilaparotomy.

Results

Surgery was performed for 24 women with a mean age of 57.54 years and a mean BMI of 32.54 kg/m2. The operative time was prolonged by about 1 h without excess blood loss or prolongation of their hospital stay. Except for a single case of partial flap necrosis, no single total flap loss was recorded. In three patients (12.5 %), the flap volume was inadequate, and silicone implant was used as an adjunct. Only one patient (4 %) experienced a small incisional hernia. The majority of the patients (67 %) described their cosmetic outcome as excellent.

Conclusion

Delivery of a pedicled omental flap via a minilaparotomy is a safe and reliable method for immediate breast reconstruction after skin-sparing mastectomy in women with a BMI higher than 30 kg/m2.

Level of Evidence V

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.

Keywords

Omental flap Mastectomy Breast cancer 

References

  1. 1.
    Delgado F, Pedraza MJL, Blasco JA, Aragones EA, Mendez JIS, Miralles GS, Reza MM (2008) Satisfaction with and psychological impact of immediate and deferred breast reconstruction. Ann Oncol 19:1430–1434CrossRefGoogle Scholar
  2. 2.
    Agarwal S, Liu JH, Crisera CA et al (2010) Survival in breast cancer patients undergoing immediate breast reconstruction. Breast J 16:503–509PubMedCrossRefGoogle Scholar
  3. 3.
    Elder EE, Brandberg Y, Bjorklund T et al (2005) Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study. Breast 14:201PubMedCrossRefGoogle Scholar
  4. 4.
    Kroll SS, Khoo A, Singletary SE et al (1999) Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up. Plast Reconstr Surg 104:421–425PubMedCrossRefGoogle Scholar
  5. 5.
    Franco HM, Vasconez LO, Fix RJ, Heslin MJ et al (2002) Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer. Ann Surg 235:814–819CrossRefGoogle Scholar
  6. 6.
    Jahkola T, Asko-Seljavaara S, Von Smitten K (2003) Immediate breast reconstruction. Scand J Surg 92:249–256PubMedGoogle Scholar
  7. 7.
    Christensen BO, Overgaard J, Kettner LO, Damsgaard TE (2011) Long-term evaluation of postmastectomy breast reconstruction. Acta Oncol 50:1053–1061PubMedCrossRefGoogle Scholar
  8. 8.
    Olivari N (1976) The latissimus flap. Br J Plast Surg 29:126–128PubMedCrossRefGoogle Scholar
  9. 9.
    Banic A, Boeckx W, Greulich M, Guelickx P, Marchi A, Rigotti G, Tschopp H (1995) Late results of breast reconstruction with free TRAM flaps: a multicentric study. Plast Reconstr Surg 95:1195–1204PubMedCrossRefGoogle Scholar
  10. 10.
    Momoh AO, Colakoglu S, Westvik TS, Curtis MS, Yueh JH, de Blacam C, Tobias AM, Lee BT (2012) Analysis of complications and patient satisfaction in pedicled transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flap breast reconstruction. Ann Plast Surg 69:19–23PubMedCrossRefGoogle Scholar
  11. 11.
    Kiricuta I (1963) The use of the great omentum in the surgery of breast cancer. Presse Med 71:5–21Google Scholar
  12. 12.
    Arnold PG, Hartrampf CR, Jurkiewicz MJ (1976) One-stage reconstruction of the breast using the transposed greater omentum: case report. Plast Reconstr Surg 57:520–522PubMedCrossRefGoogle Scholar
  13. 13.
    Saltz R, Stowers R, Smith M, Gadacz TR (1993) Laparoscopically harvested omental free flap to cover a large soft tissue defect. Ann Surg 217:542–546PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Costa SS, Pedrini JL, Recamonde A, Penczek F (1998) Tratamento cirúrgico da syndrome de Poland com omento transposto por Videolaparoscopia. Paper presented at the XI Congresso Brasileiro de Mastologia, Foz do Iguaçu-Paraná: XI Congresso Brasileiro de Mastologia, p 186Google Scholar
  15. 15.
    Costa SS, Blotta RM, Mariano MB et al (2010) Aesthetic improvements in Poland’s syndrome treatment with omentum flap. Aesthetic Plast Surg 34:634–639CrossRefGoogle Scholar
  16. 16.
    Das SK (1976) The size of the human omentum and methods of lengthening it for transplantation. Br J Plast Surg 29:170–174PubMedCrossRefGoogle Scholar
  17. 17.
    Zaha H, Inamine S (2010) Laparoscopically harvested omental flap: results for 96 patients. Surg Endosc 24:103–107PubMedCrossRefGoogle Scholar
  18. 18.
    Song XY, Guan DD, Lin H, Dai Y, Zheng XY, Zhu YP, Wang XF (2011) Immediate breast reconstruction using laparoscopically harvested omental flap after breast-conserving surgery. Zhonghua Zheng Xing Wai Ke Za Zhi 27:401–405PubMedGoogle Scholar
  19. 19.
    Lowery JC, Wilkins EG, Kuzon WM (1996) Evaluation of aesthetic results in breast reconstruction: an analysis of reliability. Ann Plast Surg 36:601–607PubMedCrossRefGoogle Scholar
  20. 20.
    Zaha H, Inamine S, Naito T, Nomura H (2006) Laparoscopically harvested omental flap for immediate breast reconstruction. Am J Surg 192:556–558PubMedCrossRefGoogle Scholar
  21. 21.
    Cothier-Savey I, Tamtawi B, Dohnt F, Raulo Y, Baruch J (2001) Immediate breast reconstruction using a laparoscopically harvested omental flap. Plast Reconstr Surg 107:1156–1163; discussion 1164–1165PubMedCrossRefGoogle Scholar
  22. 22.
    Van Garderen, Wiggers TH, Van Geel AN (1991) Complications of the pedicled omentoplasty. Neth J Surg 43:1171–1174Google Scholar
  23. 23.
    Contant CME, Van Geel AN, Van der Holt B, Wiggers T (1996) The pedicled omentoplasty and split skin graft (POSSG) for reconstruction of large chest wall defect: a validity study of 34 patients. Eur J Surg Oncol 22:532–537PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  1. 1.Mansoura Oncology Center (OCMU), Mansoura faculty of medicineMansoura UniversityMansouraEgypt

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