Oncoplastic breast reconstruction with single-port laparoscopically harvested omental flap: insights from a ten-year tertiary center experience.

IF 3 3区 医学 Q2 ONCOLOGY
Breast Cancer Research and Treatment Pub Date : 2025-04-01 Epub Date: 2024-12-10 DOI:10.1007/s10549-024-07571-9
K-H Yoon, S-H Ahn, H-C Shin, H W Koh, J K-H Park, Y Myung, J H Jeong, C Y Heo, E-K Kim
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Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

单孔腹腔镜下网膜瓣切除的肿瘤乳房重建:来自十年三级中心经验的见解。
目的:评价单孔腹腔镜大网膜瓣(SLOF)用于乳腺癌术后即刻乳房重建的10年功能和肿瘤预后。腹腔镜下大网膜皮瓣重建乳房的技术可行性和肿瘤安全性仍然存在争议。方法:我们对2015年2月至2024年3月在我院行保留乳头乳房切除术或保乳手术后立即进行SLOF重建的236例乳腺癌患者(包括2例恶性叶状瘤患者)进行了研究。评估了短期和长期结果。使用三组评估和首尔乳房美学评分工具对美容结果进行评估,并与接受上腹部深下穿支(DIEP)皮瓣乳房重建的匹配队列患者进行比较。结果:Clavien-Dindo IIIa级及以上临床显著并发症发生率为3.8%(9/236)。2例皮瓣失败的患者需要皮瓣切除和转换到其他重建程序。SLOF组和DIEP组美容满意率分别为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%。所有患者每年通过食管胃十二指肠镜检查胃癌,无因胃切除术而延迟皮瓣切除的病例。结论:SLOF手术是安全可行的。重建乳房的自然轮廓和质地以及腹部单孔切口几乎看不见的疤痕提供了优于其他重建方法的良好美容效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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