The oncoplastic breast surgery with pedicled omental flap harvested by laparoscopy: initial experiences from China

World Journal of Surgical Oncology

Xiangyang Song¹  Kexin Meng¹  Ying Xin¹  Zhenye Lv¹  Hui Lin²  Dandan Guan¹ 

[1] Department of Breast and Thyroid Surgery, Zhejiang Provincial People’s Hospital, 158 Shang Tang Road, Hangzhou 310014, Zhejiang Province, China;Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qing Chun Road, Hangzhou 310016, Zhejiang Province, China

关键词: Laparoscopy;    Omental flap;    Oncoplastic breast surgery;    Breast-conserving surgery;    Breast cancer;   

Others  :  1137176
DOI  :  10.1186/s12957-015-0514-9

 received in 2014-11-24, accepted in 2015-02-14,  发布年份 2015

【 摘 要 】

Background

A new technique of oncoplastic breast surgery (OBS) using laparoscopically harvested pedicled omental flap has been developed in the past 10 years. This study aimed to evaluate the feasibility of this technique.

Methods

Twenty-five patients underwent OBS using laparoscopically harvested omental flap. Operative time, blood loss, complications, recurrence, and cosmetic outcomes were prospectively analyzed.

Results

Between June 2010 and March 2014, 25 patients were recruited in our study. The surgery was performed successfully in 24 patients. All these patients recovered uneventfully after the surgery. Mean operative time was 310 min, ranging from 205 to 410 min. Mean blood loss was 70 ml, ranging from 20 to 150 ml. Patients were followed up for 32 months on average, ranging from 6 to 51 months. Four patients complained of mild epigastric discomfort. One patient had local recurrence and distant bone and liver metastasis and died 11 months after the surgery. One patient was diagnosed with metastases in the lung, bone, and liver without local recurrence 2 years after surgery. The cosmetic satisfaction rate was 91.7% and 95.8% by surgeon and patients, respectively.

Conclusion

OBS with laparoscopically harvested omental flap might be a feasible technique with a good cosmetic outcome.

【 授权许可】

   
2015 Guan et al.; licensee BioMed Central.

【 图 表 】

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【 参考文献 】

• [1]Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al.: Twenty-year follow up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002, 347(16):1233-41.
• [2]Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al.: Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002, 347(16):1227-32.
• [3]Li J, Zhang BN, Fan JH, Pang Y, Zhang P, Wang SL, et al.: A nation-wide multicenter 10-year (1999–2008) retrospective clinical epidemiological study of female breast cancer in China. BMC Cancer 2011, 11:364. BioMed Central Full Text
• [4]Blondeel PN, Hijjawi J, Depypere H, Roche N, Van Landuyt K: Shaping the breast in aesthetic and reconstructive breast surgery: an easy three-step principle. Part III–reconstruction following breast conservative treatment. Plast Reconstr Surg 2009, 124(1):28-38.
• [5]Cothier-Savey I, Tamtawi B, Dohnt F, Raulo Y, Baruch J: Immediate breast reconstruction using laparoscopically harvested omental flap. Plast Recontr Surg 2001, 107(5):1156-63.
• [6]Jimenez AG, St Germain P, Sirois M, Hatheway M, Lethbridge R: Free omental flap for skin-sparing breast reconstruction harvested laparoscopically. Plast Recontr Surg 2002, 110(2):545-51.
• [7]Zaha H, Inamine S, Naito T, Nomura H: Laparoscopically harvested omental flap for immediate breast reconstruction. Am J Surg 2006, 192(4):556-8.
• [8]Zaha H, Inamine S: Laparoscopically harvested omental flap: results for 96 patients. Surg Endosc 2010, 24(1):103-7.
• [9]Zaha H, Sunagawa H, Kawakami K, Touyama T, Yonaha T, Ohshiro N: Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap. World J Surg 2010, 34(8):1782-7.
• [10]Kroll SS, Baldwin B: A comparison of outcomes using three different methods of breast reconstruction. Plast Reconstr Surg 1992, 90(3):455-62.
• [11]Rose MA, Olivotto I, Cady B, Koufman C, Osteen R, Silver B, et al.: Conservative surgery and radiation therapy for early breast cancer: long-term cosmetic results. Arch Surg 1989, 124(11):153-7.
• [12]Kiricuta I: The use of the great omentum in the surgery of breast cancer. Presse Med 1963, 71(5):15-7.
• [13]Saltz R, Stowers R, Smith M, Gadacz TR: Laparoscopically harvested omental free flap to cover a large soft tissue defect. Ann Surg 1993, 217(5):542-7.