Clinical analysis of breast reconstruction with endoscopic-assisted harvesting of latissimus dorsi muscle flap for breast cancer
Objective To investigate the benefits and drawbacks of breast reconstruction with endoscopic-assisted harvesting of the latissimus dorsi muscle flap for breast cancer and treatment experience of postoperative operation-related complications.Methods A retrospective analysis was performed on clinical data of 26 female patients with breast cancer who met the selection criteria between September 2021 and March 2023 aging 48.7 years(range,26-69 years).All tumors were unilateral,with 17 on the left side and 9 on the right side.The tumor size ranged from 1.0 to 7.0 cm,with an average of 2.7 cm.The pathological staging included T1 in 11 cases,T2 in 14 cases,and T3 in 1 case;N0 in 10 cases,N,in 11 cases,N2 in 2 cases,and N3 in 3 cases;no distant metastasis(M0)occurred when first diagnosed.Among them,10 cases underwent breast conserving surgery,and 16 cases underwent nipple-sparing mastectomy.All patients underwent breast reconstruction with endoscopic-assisted harvesting of the latissimus dorsi muscle flap.The operation time,incision length,and postoperative drainage volume in 3 days were recorded.Breast-Q"Satisfaction with back"scale was conducted to evaluate patients'satisfaction with back at 6 months after operation.Results The operation time was 280-480 minutes(mean,376.7 minutes),the incision length was 10-15 cm(mean,12.2 cm),the postoperative drainage volume in 3 days was 500-1 600 mL(mean,930.2 mL).There were 4 cases of postoperative seroma,1 case of incision rupture,1 case of paresthesia of the thoracic wall,and 1 case of edema of the ipsilateral upper limb.All patients were followed up 12-30 months(mean,20.1 months).No latissimus dorsi muscle flap necrosis,latissimus dorsi muscle atrophy,or shoulder joint dysfunction occurred during follow-up;2 patients had recurrence of lymph nodes in the ipsilateral axilla after operation,but no distant metastasis occurred.Breast-Q score at 6 months after operation was 64-100(mean,79.5).The average score was 78.6(range,64-100)in patients underwent nipple-sparing mastectomy and 81.0(range,78-100)in patients underwent breast conserving surgery.Conclusion Breast reconstruction with endoscopic-assisted harvesting of the latissimus dorsi muscle flap for breast cancer is proven to be a surgical approach with safety and cosmetic effects with mild postoperative operation-related complications and considerable patient satisfaction.
Breast cancerbreast reconstructionlatissimus dorsi muscle flapsingle-port endoscope
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