Endoscopic axillary lymphadenectomy combined with laparoscopically harvested pedicled omentum for immediate breast reconstruction
To determine the therapeutic and cosmetic outcomes of patients with breast cancer treated with endoscopic axillary lymphadenectomy (EAL) combined with laparoscopically harvested pedicled omentum (LHPO) for immediate breast reconstruction.
Forty patients with early breast cancer underwent EAL, followed by quadrantectomy and LHPO for immediate breast reconstruction. All patients were evaluated for operating time, blood loss, postoperative hospital stay, complications, etc. The cosmetic outcomes were evaluated 6 months after the surgery, according to the Harris criteria.
The average operating time was 308 min, including 39 min for EAL, 63 min for quadrantectomy, and 58 min for LHPO. The average blood loss was 70 ml, and was mainly incurred during breast resection. On average, the patients were discharged 9.5 days after the surgery. Partial graft necrosis and omental fat liquefaction occurred in one patient each. No other complications occurred after the surgery. No local recurrence or distant metastasis was found during the follow-up. The cosmetic results were mostly satisfactory. No size reduction of the reconstructed breast occurred after radiation therapy. Esthetic evaluation of the reconstructed breast showed that the cosmetic outcome was “excellent” in 35 patients, “good” in 4 patients, and “fair” in 1 patient.
EAL combined with LHPO for breast reconstruction is a viable, safe procedure that causes minimal surgical trauma and results in a soft, shapely breast postoperatively.
KeywordsLaparoscopic technique Pedicled omentum Axillary lymphadenectomy Breast reconstruction
- 1.Veronesi U, Salvadori B, Luini A, Greco M, Saccozzi R, Del VM, Mariani L, Zurrida S, Rilke F (1995) Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients. Eur J Cancer 31A:1574–1579CrossRefPubMedGoogle Scholar
- 12.Luo C, Guo W, Yang J, Sun Q, Wei W, Wu S, Fang S, Zeng Q, Zhao Z, Meng F, Huang X, Zhang X, Li R, Ma X, Luo C, Yang Y (2012) Comparison of mastoscopic and conventional axillary lymph node dissection in breast cancer: long-term results from a randomized, multicenter trial. Mayo Clin Proc 87:1153–1161CrossRefPubMedCentralPubMedGoogle Scholar
- 14.Gomatos IP, Filippakis G, Albanopoulos K, Zografos G, Leandros E, Bramis J, Konstadoulakis MM (2006) Complete endoscopic axillary lymph node dissection without liposuction for breast cancer: initial experience and mid-term outcome. Surg Laparosc Endosc Percutan Technol 16:232–236CrossRefGoogle Scholar
- 17.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):1164–1165Google Scholar