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Oncoplastic surgery with omental flap reconstruction: a study of 200 cases

A Letter to the Editor to this article was published on 15 March 2017

Abstract

Background

There are several small case series on use of a laparoscopically harvested omental flap (LHOF) for breast reconstruction. However, the long-term oncological safety and clinical benefits of the LHOF remain uncertain, especially in use of the flap in oncoplastic breast surgery.

Study design

A retrospective chart review was performed for 200 patients who underwent oncoplastic breast surgery using a LHOF at our institution from April 2002 to March 2016. Laparoscopy-associated complications, local recurrence, and cosmetic outcomes were evaluated.

Results

Most of the patients underwent partial breast reconstruction immediately after breast-conserving surgery (BCS). The success rate of laparoscopic harvesting of the omental flap was 99.5%. The rate of complications was 12.0% and laparoscopy-associated complications occurred in four cases (2.0%). The rate of a positive margin was 6.5%. Two cases (1.0%) had local recurrence during a median follow-up period of 90 months. In 24 patients (12.0%), the volume of the flap was insufficient. When applied to total reconstruction, volume insufficiency occurred in 32.6% of patients. Cosmetic outcomes were mostly satisfactory. Approximately 80% of patients were rated as good or excellent by evaluation using a 4-point scale and Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software. Donor-site scars were negligible, as in laparoscopic cholecystectomy.

Conclusions

The LHOF has minimal donor-site morbidity and deformity, and oncological safety is promising. There is a limit to the adaptable volume, but the LHOF is an attractive option in partial breast reconstruction after BCS.

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Abbreviations

LHOP:

Laparoscopically harvested omental flap

BCS:

Breast-conserving surgery

LD:

Latissimus dorsi

GEA:

Gastroepiploic artery

BCT:

Breast-conserving treatment

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Correspondence to Hisamitsu Zaha.

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The authors have declared no conflict of interest.

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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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Informed consent was obtained from all subjects in the study.

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Zaha, H., Abe, N., Sagawa, N. et al. Oncoplastic surgery with omental flap reconstruction: a study of 200 cases. Breast Cancer Res Treat 162, 267–274 (2017). https://doi.org/10.1007/s10549-017-4124-9

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Keywords

  • Omental flap
  • Laparoscopy
  • Oncoplastic surgery
  • Breast-conserving surgery
  • Breast reconstruction