Mastectomy with Immediate Latissimus Dorsi Flap Reconstruction

Authors

  • Chayanoot Rattadilok Department of Surgery, Nopparatrajathanee Hospital, Bangkok, Thailand
  • Prakasit Chirappapha Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University Bangkok, Thailand
  • Prapa Rattadilok School of Computer Science, University of Nottingham Ningbo China

Keywords:

Extended latissimus dorsi flap, Latissimus dorsi flap with prosthesis, Flap complication, Breast reconstruction, Donor site seroma

Abstract

Latissimus dorsi (LD) muscle is often used for breast reconstruction in cancer patients, i.e. a breast conserving therapy (BCT) or a mastectomy, often in combination with a breast implant or a tissue expander. The shape of the reconstructed breasts using LD flap with breast implant may look like natural breasts, but may slightly impact shoulder movements, particularly in the extension and the adduction of the shoulder. With the appropriate choice of surgical methods, postoperative complications are minimal and a fast recovery can be expected. In the present article we review the techniques of breast reconstruction with the LD flap in patients with breast cancer undergoing mastectomy, using illustrative cases, as well as detailing the indications, technical pitfalls, and avoidance of complications.

References

Maxwell GP. Iginio Tansini and the origin of the latissimus dorsi musculocutaneous flap. Plast Reconstr Surg 1980;65:686-92.

Lassen M, Krag C, Nielsen IM. The latissimus dorsi flap: an overview. Scand J Plast Surg 1985;19:41-51.

Schneider WJ, Hill HL, Brown RG. Lastissimus dorsi myocutaneous flap for breast reconstruction. Br J Plast Surg 1977;30:277-81.

Maxwell GP, McGibbon BM, Hoopes JE. Vascular consideration in the use of a latissimus dorsi myocutaneous flap after a mastectomy with an axillary dissection. Plast Reconstr Surg 1979;64:771-80.

Laitung JKG, Peck F. Shoulder function following the loss of the latissimus dorsi muscle. Br J Plast Surg 1985;38:375-9.

Russell RC, Pribaz J, Zook EG, et al. Functional evaluation of latissimus dorsi donor site. Plast Reconstr Surg 1986;78:336-44.

Chang DW, Kroll SS, Dackiw A, et al. Reconstruction management of contralateral breast cancer in patients who previously underwent unilateral breast reconstruction. Plast Reconstr Surg 2001;108:352-8.

Clough KB, Kroll SS, Audretsch W. An approach to the repair of partial mastectomy defects. Plast Reconstr Surg 1999;104:409-20.

Lejour M, Alemanno P, De mey A, et al. Analysis of fifty-six breast reconstruction using the latissimus dorsi flap. Ann Chir Plast Esthet 1985;30:7-16.

Pendergrast WJ, Bostwick JB III, Jurkiewicz MJ. The subcutaneous mastectomy cripple: surgical rehabilitation with the latissimus dorsi flap. Plast Reconstr Surg 1980;66:554-9.

Spear SL, Slack C, Howard MA. Postmastectomy reconstruction of the previously augmented breast: diagnosis, staging, methodology, and outcome. Plast Reconstr Surg 2001;107:1167-76.

Bailey S, Saint-Cyr M, Zhang K, et al. Breast reconstruction with latissimus dorsi flap: Woman’s preference for scar location. Plast Reconstr Surg 2010;126:358-65.

Saint-Cyr M, Nagarkar P, Schaverien M, et al. The pedicled descending branch muscle-sparing latissimus dorsi flap for breast reconstruction. Plast Reconstr Surg 2009;123:13-24.

Schwabegger AH, Harpf C, Rainer C. Muscle-sparing latissimus dorsi myocutaneous flap with maintenance of muscle innervation, function, and aesthetic appearance of the donor site. Plast Reconstr Surg 2003;111:1407-11.

Chang DW, Youssef A, Cha S, et al. Autologous breast reconstruction with the extended latissimus dorsi flap. Plast Reconstr Surg 2002;110:751-9; discussion 60-1.

Lee JW, Chang TW. Extended latissimus dorsi musculocutaneous flap for breast reconstruction: experience in Oriental patients. Br J Plast Surg 1999;52:365-72.

Tomita K, Yano K, Masuoka T, et al. Postoperative seroma formation in breast reconstruction with latissimus dorsi flaps: a retrospective study of 174 consecutive cases. Ann Plast Surg 2007;59:149-51.

Pinsolle V, Grinfeder C, Mathoulin-Pelissier S, et al. Complications analysis of 266 immediate breast reconstructions. JPRAS. 2006;59:1017-24.

Clough KB, Louis-Sylvestre C, Fitoussi A, et al. Donor site sequelae after autologous breast reconstruction with an extended latissimus dorsi flap. Plast Reconstr Surg 2002;109:1904-11.

Mendelson BC. Latissimus dorsi breast reconstruction--refinement and results. Br J Surg 1983;70:145-9.

Moore TS, Farrell LD. Latissimus dorsi myocutaneous flap for breast reconstruction: long-term results. Plast Reconstr Surg 1992;89:666-72; discussion 73-4.

Venus MR, Prinsloo DJ. Immediate breast reconstruction with latissimus dorsi flap and implant: audit of outcomes and patient satisfaction survey. JPRAS 2010;63:101-5.

Kim H, Wiraatmadja ES, Lim SY, et al. Comparison of morbidity of donor site following pedicled muscle-sparing latissimus dorsi flap versus extended latissimus dorsi flap breast reconstruction. JPRAS 2013;66:640-6.

Jeon BJ, Lee TS, Lim SY, et al. Risk factors for donor-site seroma formation after immediate breast reconstruction with the extended latissimus dorsi flap: a statistical analysis of 120 consecutive cases. Ann Plast Surg 2012;69:145-7.

Chirappapha P, Rattadilok C, Lertsithichai P, et al. Predictor of donor site seroma in latissimus dorsi flap. J Med Assoc Thai 2017;100(Suppl 9):S103-S114.

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Published

2020-06-30

How to Cite

1.
Rattadilok C, Chirappapha P, Rattadilok P. Mastectomy with Immediate Latissimus Dorsi Flap Reconstruction. Thai J Surg [Internet]. 2020 Jun. 30 [cited 2024 Mar. 29];41(2):52-64. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/240114

Issue

Section

Surgical Techniques