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العنوان
Evaluation of Early vs Late Latissimus Dorsi Flap Reconstruction for Breast Cancer Patients in Egypt \
المؤلف
Abdel Al, Ahmed Abdel Hakim Hassan.
هيئة الاعداد
باحث / أحمد عبد الحكيم حسن عبدالعال
مشرف / محمد حلمي شهاب
مشرف / عمرو حامد عفيفي
مناقش / محمد حلمي شهاب
تاريخ النشر
2019.
عدد الصفحات
177 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الطب الباطني
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - الجراحة العامة
الفهرس
Only 14 pages are availabe for public view

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from 177

Abstract

B
reast reconstruction plays an important role in the multidisciplinary, comprehensive care of the breast cancer patient. Advances in techniques have allowed immediate reconstruction to minimize incisional scars on the breast and improve overall breast contour, shape, and appearance.
So, the purpose of this study was to critically compare the outcomes between early and late latissimus dorsi myocutaneous flap reconstruction as regards cosmetic outcome, complication rate and recurrence rate for female breast cancer patients in Egypt.
This retrospective study included 60 patients who underwent Latissimus-Dorsi Flap reconstructions for breast cancer in Nasser Institute Hospital and Ain Shams University Hospitals between January 2013 and December 2016. Two groups were studied the first was the immediate reconstruction group and the second was the late reconstruction group.
All patients data were analyzed retrospectively thoroughly as regards: history, breast pathology, type and timing of procedure underwent, cosmetic outcome, as regard flaps viability and breast contour, complications rate, recurrence rate as detected by, regular sonomammography and clinical examination. a follow up period was of at least 1 year postoperatively.
This study found that, overall patients᾽ age ranged from 23 to 48 years with a mean of 35.38 years. The majority of patients (93.3%) had invasive ductal carcinoma while (6.7%) had invasive lobular carcinoma, with a cancer stage of I (36.7%) or II (48.3%). None of patients had silicone or other co-morbid conditions. About 73% of patients underwent Modified Radical Mastectomy (MRM), while 27% underwent Conservative Breast Surgery (CBS) for their breast cancer. All patients have received adjuvant CTH while 68.3% have received the adjuvant RTH. No statistically significant difference between the two groups regarding the age of the patients or the receipt of adjuvant RTH.
However, there was a statistically significant association between the timing of reconstruction and stage of the cancer (p-value = 0.003) and the type of operation (p-value < 0.001).
All patients with low-stage breast cancer (I or II) underwent the immediate reconstruction, while advanced cancer stages (IIIa or IIIb) tended to have delayed reconstruction. Also, all patients who underwent delayed reconstruction surgery had modified radical mastectomy, while those who underwent immediate reconstruction had either MRM (46.7%) or CBS (53.3%).
Donor site seroma was the most common postoperative complications and was more frequent among patients with immediate reconstruction. Other complications were also more frequent with immediate reconstruction. Recurrence occurred in one patient (3.3%) who underwent immediate reconstruction.
Although the immediate reconstruction showed better cosmetic satisfaction than the delayed reconstruction (83.3% versus 70.0%), it has been associated with more post-operative complications. However, these differences were not statistically significant.
In conclusion, a high degree of satisfaction among both groups of patients was achieved and the results were acceptable, with few complications.
So, we recommended more prospective studies to be done with larger sample size to evaluate role of timing in reconstruction surgeries among breast cancer patients.