Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea.
Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
Breast Cancer Res Treat. 2020 Nov;184(2):375-384. doi: 10.1007/s10549-020-05848-3. Epub 2020 Aug 6.
Immediate breast reconstruction using laparoscopically harvested omental flap is a safe and feasible technique, providing natural contour and softness to reconstructed breasts with reduced donor-site morbidity and deformity. We report our experience using single-port laparoscopically harvested omental flap (SLOF) for immediate breast reconstruction.
Between February 2015 and December 2018, 129 patients with malignant neoplasm of the breast underwent nipple-sparing mastectomy (NSM) or breast-conserving surgery (BCS) followed by immediate SLOF reconstruction at Seoul National University Bundang Hospital. We assessed their clinicopathological data, complications, and cosmetic and oncologic outcomes. Cosmetic outcomes were evaluated by three-panel assessment and the BCCT.core software program.
One hundred and six (82.2%) underwent NSM and 23 (17.8%) underwent BCS. Mean operation time was 205 (range, 134-316) minutes. Most patients had early-stage disease; 15 (11.6%) received neoadjuvant chemotherapy. Two had malignant phyllodes tumors. Cosmetic outcomes were excellent or good in 96.9% by three-panel assessment and 99.2% by the BCCT.core program with a nearly invisible donor-site scar in the umbilicus. Harvest-associated complications occurred in five (3.9%) patients, including two umbilical wound infections, one intra-abdominal infection, one umbilical hernia, and one pedicle injury. Fat necrosis (13.2%) and epigastric bulging (21.7%) were common mastectomy- or reconstruction-associated complications, but most were mild and some resolved spontaneously. Over a median 38-month follow-up, there were three local, two regional, and three systemic recurrences.
SLOF reconstruction is a feasible and safe option for immediate breast reconstruction after NSM or extensive BCS with minimal donor-site morbidity and great cosmetic outcomes.
利用腹腔镜采集的网膜瓣即刻乳房重建是一种安全可行的技术，可提供自然的轮廓和柔软度，减少供区发病率和畸形。我们报告了使用单孔腹腔镜采集的网膜瓣（SLOF）进行即刻乳房重建的经验。
2015 年 2 月至 2018 年 12 月，在首尔国立大学盆唐医院，129 例乳腺癌患者接受了保乳手术（BCS）或保留乳头的乳房切除术（NSM），随后进行了即刻 SLOF 重建。我们评估了他们的临床病理数据、并发症以及美容和肿瘤学结果。通过三面板评估和 BCCT.core 软件程序评估美容结果。
106 例（82.2%）接受了 NSM，23 例（17.8%）接受了 BCS。平均手术时间为 205 分钟（范围，134-316 分钟）。大多数患者患有早期疾病；15 例（11.6%）接受了新辅助化疗。2 例为恶性叶状肿瘤。三面板评估的美容效果为 96.9%，BCCT.core 程序的美容效果为 99.2%，脐部几乎看不到供区瘢痕。5 例（3.9%）患者发生与采集相关的并发症，包括 2 例脐部伤口感染、1 例腹腔内感染、1 例脐疝和 1 例蒂损伤。脂肪坏死（13.2%）和上腹膨隆（21.7%）是常见的乳房切除术或重建相关并发症，但大多数为轻度，有些可自行缓解。在中位 38 个月的随访中，有 3 例局部复发、2 例区域复发和 3 例全身复发。
SLOF 重建是 NSM 或广泛 BCS 后即刻乳房重建的一种可行且安全的选择，供区发病率低，美容效果好。
