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Breast reconstruction with flaps from the lower abdomen

Wiederherstellung der Brust mit Lappen vom Abdomen

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Zusammenfassung

GRUNDLAGEN: Die Abdominalregion ist eine vielseitige Quelle für mehrere Gewebe, welche als Lappen zur Wiederherstellung der weiblichen Brust geeignet sind. Diese beinhalten den gestielten und freien Transverse Rectus Abdominis Myocutaneous Lappen (TRAM), den Deep Inferior Epigastric Perforator Lappen (DIEAP) und den Superficial Inferior Epigastric Lappen (SIEA). METHODIK: Diese Übersicht stellt Geschichte und Technik der Wiederherstellung der Brust mittels Lappen vom Abdomen dar. Alle relevanten Studien und Erfahrungen wurden berücksichtigt. ERGEBNISSE: Der Entscheidungsprozess zur Lappenwahl ist komplex und abhängig von einer Reihe von Faktoren, wobei Lappen mit niedrigerer Hebemorbidität deutliche Vorteile zeigen und ein postoperativ verbessertes ästhetisches Resultat der Hebestelle die Patientenakzeptanz deutlich erhöhen kann. SCHLUSSFOLGERUNGEN: In dieser Übersicht werden Anatomie und präoperative Planung in dieser Spenderregion, Fragen zur intraoperativen Entscheidungsfindung sowie Resultate und Patientenzufriedenheit behandelt.

Summary

BACKGROUND: The lower abdominal region offers a multitude of flaps for breast reconstruction, which include the pedicled and free transverse rectus abdominis myocutaneous flap (TRAM), the deep inferior epigastric artery perforator flap (DIEAP), and the superficial inferior epigastric artery flap (SIEA). METHODS: This literature overview examines the history and the practice of breast reconstruction using flaps from the lower abdomen. All relevant studies and experiences have been included. RESULTS: The decision-making process in regard of the choice of flap to use is complex and depends on a variety of factors. A clear trend in using flaps which lower donor site morbidity and higher aesthetic outcome is seen. CONCLUSIONS: This article serves to review surgical anatomy, preoperative planning, intraoperative decision making in flap elevation, and reported outcomes in terms of complications and patient satisfaction.

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  1. Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Basel, Basel, Switzerland

    J. Farhadi & G. Pierer

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  1. J. Farhadi
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  2. G. Pierer
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Correspondence to J. Farhadi.

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Farhadi, J., Pierer, G. Breast reconstruction with flaps from the lower abdomen. Eur Surg 39, 216–226 (2007). https://doi.org/10.1007/s10353-007-0350-4

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  • DOI: https://doi.org/10.1007/s10353-007-0350-4

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