Stephen J McCulley1, Mark V Schaverien2, Veronique K M Tan3, R Douglas Macmillan3. 1. Department of Plastic Surgery, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK. 2. Department of Plastic Surgery, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK. Electronic address: markschaverien@fastmail.fm. 3. Nottingham Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK.
Abstract
BACKGROUND: Partial breast reconstruction using pedicled perforator flaps from the thoracodorsal (TDAP) and lateral intercostal arteries (LICAP) is well described. The article introduces the lateral thoracic artery perforator (LTAP) flap as an additional valuable option from the lateral chest wall and reports clinical experience and outcomes. METHODS: The anatomy of the LTAP flap is reviewed and the results of a consecutive series are reported. RESULTS: In a series of 75 consecutive cases of lateral chest wall perforator flaps used for reconstruction of partial breast defects, 12 (17%) were raised as pure LTAP flaps, and a further 19 (27%) as combined LTAP/LICAP flaps. The LTAP was therefore used in 44% of flaps overall. One LTAP flap (delayed case) had early venous compromise that settled spontaneously. DISCUSSION: The LTAP flap is a reliable option for partial breast reconstruction from the lateral chest wall, particularly in the immediate setting. It allows comparable flap size to be harvested compared to LICAP flaps. The LTAP flap can be raised on its own pedicle allowing greater mobilization or it can be incorporated into the more commonly used LICAP flap to augment perfusion.
BACKGROUND: Partial breast reconstruction using pedicled perforator flaps from the thoracodorsal (TDAP) and lateral intercostal arteries (LICAP) is well described. The article introduces the lateral thoracic artery perforator (LTAP) flap as an additional valuable option from the lateral chest wall and reports clinical experience and outcomes. METHODS: The anatomy of the LTAP flap is reviewed and the results of a consecutive series are reported. RESULTS: In a series of 75 consecutive cases of lateral chest wall perforator flaps used for reconstruction of partial breast defects, 12 (17%) were raised as pure LTAP flaps, and a further 19 (27%) as combined LTAP/LICAP flaps. The LTAP was therefore used in 44% of flaps overall. One LTAP flap (delayed case) had early venous compromise that settled spontaneously. DISCUSSION: The LTAP flap is a reliable option for partial breast reconstruction from the lateral chest wall, particularly in the immediate setting. It allows comparable flap size to be harvested compared to LICAP flaps. The LTAP flap can be raised on its own pedicle allowing greater mobilization or it can be incorporated into the more commonly used LICAP flap to augment perfusion.
Authors: Michael Rose; Henry Svensson; Jürgen Handler; Ute Hoyer; Anita Ringberg; Jonas Manjer Journal: Breast Cancer Res Treat Date: 2020-01-27 Impact factor: 4.872