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The traditional versus endoscopic-assisted latissimus dorsi harvest in oncoplastic surgery: A long term comparison of breast volume, aesthetics, and donor site outcomes

Authors
 Hsien Pin Chang  ;  Kenneth L Fan  ;  Seung Yong Song  ;  Dong Won Lee 
Citation
 ASIAN JOURNAL OF SURGERY, Vol.43(12) : 1165-1171, 2020-12 
Journal Title
 ASIAN JOURNAL OF SURGERY 
ISSN
 1015-9584 
Issue Date
2020-12
Keywords
Breast ; Endoscopes ; Scar
Abstract
Background/objective: Volume replacement with the latissimus dorsi (LD) is an option for patients after partial mastectomy. Although potential benefits of using the endoscopic technique have been previously described, previous studies have not assessed long term volume and aesthetic outcomes compared to traditional methods. In this study, we aim to compare the endoscopic, latissimus only harvest to the traditional latissimus with skin paddle method. Methods: Eleven patients underwent breast reconstruction with the traditional LD flap harvesting method; 9 underwent endoscopically assisted LD flap reconstruction. The difference between preoperative and >1 year postoperative volumes were recorded. Patient satisfaction and surgeon-based observer assessment of the breast aesthetic and donor site scar were compared between the two techniques. Results: Compared to the traditional group, there was a significant mean volume reduction in the endoscopic group (70.3 vs 21.7 cc, p = 0.0023). Operative time was also longer in the endoscopic group than in the traditional group (368 vs 257 min, p < 0.001). In observer assessment criteria, the result of the donor site scar assessment was superior in the endoscopic group in terms of vascularity (p = 0.0038), relief (p = 0.0023), and pliability (p = 0.053). Conclusion: Patients' attitudes and feelings about the scar were better in the endoscopic group than in the traditional group. However, compared to the endoscopic group, the traditional group achieved a better breast cosmetic result and better retention of volume postoperatively, possibly due to incorporation of the skin flap and adipo-fascial tissue.
Files in This Item:
T202005335.pdf Download
DOI
10.1016/j.asjsur.2020.03.002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Seung Yong(송승용) ORCID logo https://orcid.org/0000-0002-3145-7463
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180805
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