Contralateral internal thoracic artery perforator flap to repair large chest wall defect or immediate breast reconstruction

doi:10.3877/cma.j.issn.1674-0807.2017.01.006

Abstract

Abstract:

Objective

To explore the feasibility and clinical value of contralateral internal thoracic artery perforator flap to repair large chest wall defect or immediate breast reconstruction in unilateral modified radical mastectomy.

Methods

A retrospective analysis of eight patients with large breast cancer in internal mammary area admitted to the First Affiliated Hospital of Anhui Medical University between July 2013 and May 2016 was conducted. Seven patients received neoadjuvant chemotherapy. All 8 patients received contralateral internal thoracic artery perforator flap to repair large chest wall defect (1 case) or immediate breast reconstruction (7 cases). All 8 patients received contralateral breast reduction and lifting, including 3 with prosthesis reconstruction and 4 with bilateral nipple-areola reconstruction during operation. Comprehensive treatment was given after operation. The operation time and hospitalization time were statistically analyzed. The flap survival and postoperative complications were observed and the patients' satisfaction with the operation outcome was investigated.

Results

The average operation time was 3.0 h (range:2.3-4.8 h). The average duration of hospitalization was 8.9 d (range: 7.0-14.0 d). The median follow-up period was 23 months(range:4-33 months). The flaps survived in eight patients. Flap congestion occurred in one case. One patient suffered from subcutaneous effusion, but recovered after drainage. No obvious complications were found in donor areas. Primary breast cancer and distant metastasis were not found in the contralateral breast. All patients were satisfied with the repair and reconstruction.

Conclusions

Contralateral internal thoracic artery perforator flap can be used for large chest wall defect repair or breast reconstruction in carefully selected patients, with the advantages of rapid recovery and low donor area morbidity. It is especially suitable for the patients with large breast cancer in internal mammary area.

Key words: Breast neoplasms, Internal mammary-coronary artery anastomosis, Surgical flaps, Reconstructive surgical procedures

Xiaodong Wu, Min Ren, Benzhong Wang, Suxia Ge, Ying Chen, Xiaowei Yang. Contralateral internal thoracic artery perforator flap to repair large chest wall defect or immediate breast reconstruction[J]. Chinese Journal of Breast Disease(Electronic Edition), 2017, 11(01): 28-32.

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References 20

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