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Autologous reconstruction for partial mastectomy defects: outcomes of latissimus versus abdominal flaps

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Abdominal flaps and latissimus dorsi flaps can be used to provide soft tissue coverage and recreate the breast mound following breast conservation therapy (BCT), which consists of lumpectomy and radiation. This study compares complication rates and the need for revision surgery between the two flap groups.

Methods

This study retrospectively reviewed charts for all patients who underwent BCT and presented for delayed partial breast reconstruction with either a free abdominal flap (MS-TRAM, DIEP, SIEA) or pedicled latissimus dorsi flap at our institution between January 2005 and August 2017. Charts were reviewed for basic demographics, comorbidities, oncologic data, postoperative complication incidence, and whether patients underwent revisionary surgery.

Results

A total of 21 patients met inclusion criteria, which included 12 latissimus (LD) and 9 abdominal (Abd) flap-based reconstructions. Demographics and comorbidities were similar between cohorts. Overall complication rates were similar between groups for both recipient site (LD: 16.7%, Abd: 22.2%; p = 0.748) and donor site (LD: 8.3%, Abd: 0.0%; p = 0.375). Overall rates of revisionary surgery were also similar in both groups (p = 0.445). Mean follow-up time was similar between the two cohorts (p = 0.227).

Conclusions

The flap choice in partial reconstruction is multi-factorial and is based largely upon surgeon experience, surgeon and patient preference, and body habitus. Our study shows that both abdominal flaps and the latissimus dorsi flap are able to reconstruct partial mastectomy defects with relatively low and comparable complication rates. Revision rates are similar between the autologous flap options as well.

Level of evidence: Level IV, Therapeutic.

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Authors and Affiliations

  1. Divison of Plastic Surgery, University of Utah Hospitals & Clinics, 30 North 1900 East, 3B400, Salt Lake City, UT, 84132, USA

    Ashraf A. Patel & Giovanna Pires

  2. Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Dominic Henn

  3. College of Medicine, Tufts University School of Medicine, Boston, MA, USA

    Amit Beniwal

  4. College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA

    Mallory A. Rowley

  5. Division of Plastic Surgery, Stanford University Medical Center, Stanford, CA, USA

    Gordon K. Lee & Rahim S. Nazerali

Authors
  1. Ashraf A. Patel
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  2. Dominic Henn
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Correspondence to Ashraf A. Patel.

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Funding statement

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. We collectively have no reportable sources of funding in relation to this study.

Patient consent

All patients included had completed the standardized hopsital informed consent form. All patient data was de-identified.

Ethics approval

All procedures performed in the study involving human participants were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki. This study was exempted and approved by the Stanford University IRB # 47054.

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The authors declare there is no conflict of interest

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Patel, A.A., Henn, D., Pires, G. et al. Autologous reconstruction for partial mastectomy defects: outcomes of latissimus versus abdominal flaps. Eur J Plast Surg 46, 197–202 (2023). https://doi.org/10.1007/s00238-022-01998-3

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  • DOI: https://doi.org/10.1007/s00238-022-01998-3

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