René Aloisio da Costa Vieira1,2, Katia Mathias Teixeira da Silva1,2, Idam de Oliveira-Junior2, Marcos Alves de Lima3. 1. Postgraduate Program in Oncology, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil. 2. Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil. 3. Center of Epidemiology and Statistics, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo, Brazil.
Abstract
BACKGROUND: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects. OBJECTIVES: Evaluate the results of a new thoracoabdominal flap (TAF). METHODS: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction. A systematic review of the flaps used in this situation was performed. RESULTS: A total of 23 patients underwent the ITADE flap. The average flap size was 360 cm2 . One (4.3%) patient presented extensive loss of the flap. In the literature review, we observed 354 patients with 159 TAFs. We added our cases to the evaluation. A significant reduction in the risk of necrosis using myocutaneous flaps versus TAFs was observed (P < 0.001). Comparing other TAFs and ITADE flaps, considering all necrosis, a significant difference was apparent (P = 0.02), which disappeared when evaluating only larger necrosis (P = 0.13). Multivariate analysis showed that the resected area was the best variable related to the presence of necrosis. CONCLUSIONS: ITADE allows extensive coverage areas, an early start of adjuvant treatment and it can be performed without requiring a reconstructive team.
BACKGROUND: Locally advanced breast cancer (LABC) is still a common problem in developing countries. Extensive resections are aimed at local control and improving quality of life. Dermofat flaps are an option for medium-sized defects. OBJECTIVES: Evaluate the results of a new thoracoabdominal flap (TAF). METHODS: We describe and evaluate an ipsilateral, thoracoabdominal horizontal, dermofat (ITADE) flap performed in patients submitted to mastectomy and immediate reconstruction. A systematic review of the flaps used in this situation was performed. RESULTS: A total of 23 patients underwent the ITADE flap. The average flap size was 360 cm2 . One (4.3%) patient presented extensive loss of the flap. In the literature review, we observed 354 patients with 159 TAFs. We added our cases to the evaluation. A significant reduction in the risk of necrosis using myocutaneous flaps versus TAFs was observed (P < 0.001). Comparing other TAFs and ITADE flaps, considering all necrosis, a significant difference was apparent (P = 0.02), which disappeared when evaluating only larger necrosis (P = 0.13). Multivariate analysis showed that the resected area was the best variable related to the presence of necrosis. CONCLUSIONS: ITADE allows extensive coverage areas, an early start of adjuvant treatment and it can be performed without requiring a reconstructive team.
Authors: René Aloisio da Costa Vieira; Luiz Carlos Navarro de Oliveira; An Wan Ching; Idam de Oliveira-Junior Journal: Plast Reconstr Surg Glob Open Date: 2022-02-22