Yoon K-H, Ahn S-H, Shin H-C, Koh H W, Park J K-H, Myung Y, Jeong J H, Heo C Y, Kim E-K
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, Republic of Korea.
Department of Plastic and Reconstructive 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, Republic of Korea.
Breast Cancer Res Treat. 2025 Apr;210(2):355-364. doi: 10.1007/s10549-024-07571-9. Epub 2024 Dec 10.
To evaluate the 10-year functional and oncological outcomes of single-port laparoscopically harvested omental flap (SLOF) for immediate breast reconstruction after breast cancer surgery. The technical feasibility and oncologic safety of breast reconstruction using a laparoscopically harvested omental flap remain controversial.
We examined 236 patients with breast cancer (including 2 patients with malignant phyllodes tumors) who underwent nipple-sparing mastectomy or breast-conserving surgery followed by immediate SLOF reconstruction between February 2015 and March 2024 at our institution. Short- and long-term outcomes were assessed. Cosmetic outcomes were evaluated using a three-panel assessment and the Seoul Breast Esthetic Scoring Tool and compared with those of a matched cohort of patients who underwent deep inferior epigastric perforator (DIEP) flap breast reconstruction.
The rate of clinically significant complications of Clavien-Dindo grade IIIa or greater was 3.8% (9/236). Two patients with flap failure required flap removal and conversion to other reconstruction procedures. The cosmetic satisfaction rates were 82.5% and 76.4% in the SLOF and DIEP groups, respectively (P = 0.467). Over a median 59-month follow-up, the local, regional, and systemic recurrence rates were 3%, 2.1%, and 3%, respectively. All patients underwent annual screening for gastric cancer via esophagogastroduodenoscopy, and there were no cases of delayed flap removal due to gastrectomy.
Oncoplastic breast reconstruction using SLOF is safe and feasible. The natural contour and texture of the reconstructed breast and the nearly invisible scar at the abdominal single-port incision provide excellent cosmetic outcomes that are superior to those of other reconstruction methods.
评估单孔腹腔镜采集网膜瓣（SLOF）用于乳腺癌手术后即刻乳房重建的10年功能和肿瘤学结局。使用腹腔镜采集网膜瓣进行乳房重建的技术可行性和肿瘤学安全性仍存在争议。
我们研究了2015年2月至2024年3月期间在本机构接受保乳乳头切除术或保乳手术并即刻进行SLOF重建的236例乳腺癌患者（包括2例恶性叶状肿瘤患者）。评估了短期和长期结局。使用三面板评估和首尔乳房美学评分工具评估美容效果，并与接受腹壁下深动脉穿支（DIEP）皮瓣乳房重建的匹配队列患者的美容效果进行比较。
Clavien-Dindo IIIa级或更高等级的临床显著并发症发生率为3.8%（9/236）。2例皮瓣失败患者需要切除皮瓣并转换为其他重建手术。SLOF组和DIEP组的美容满意率分别为82.5%和 76.4%（P = 0.467）。在中位59个月的随访中，局部、区域和全身复发率分别为3%、2.1%和3%。所有患者均通过食管胃十二指肠镜进行年度胃癌筛查，没有因胃切除术而延迟切除皮瓣的病例。
使用SLOF进行肿瘤整形乳房重建是安全可行的。重建乳房的自然轮廓和质地以及腹部单孔切口处几乎不可见的疤痕提供了优于其他重建方法的出色美容效果。
