الفهرس 
REVIEW OF LITERATURE ANATOMY OF THE BREASTOnly 14 pages are availabe for public view
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Abstract
SUMMARY
W
omen who have surgery as part of their breast cancer management should have offered the facility of the reconstruction surgery as an integral part to rebuild the breast and to offer an improved look of the breast after the cancer surgery.
There are several techniques of breast reconstruction include either autologous based reconstruction such as, free flaps such as Lateral Intercostal Artery Perforator (LICAP) flap, pedicled flaps such as Transversus Rectus Abdominus (TRAM) flap, Latissimus Dorsi (LD) flap, or device-based reconstruction, such as silicone breast implants or expanders.
Endoscopic LD flap with fat graft is a new technique of harvesting LD muscle flap to ameliorate the donor site scar and to enhance the volume of the muscle.
This study is a comparative study that compared Extended Latissimus Dorsi muscle flap versus Endoscopic Latissimus Dorsi muscle flap with fat graft in immediate breast reconstruction. This study was conducted between December 2020 to December 2021 at the Plastic, Burn and Maxillofacial Surgery Department, Faculty of Medicine, Ain Shams University.
Forty patients of early invasive breast cancer were divided into two groups. In group I (n=20) breast reconstruction was done by Extended Latissimus Dorsi muscle flap. In group II (n=20) breast reconstruction was done by Endoscopic Latissimus Dorsi muscle flap with fat graft.
In this study, female patients (25-55) years were included. BMI: 18.5 – 30 Kg/m2 was also included. Also, the study included patients with early invasive breast stage (T1-3 N0-2 M0), according to American Joint Committee on Cancer (AJCC) staging system, and breast size of 300-700 cc.
Patients less than 25 years and more than 55 years, and patients with BMI <18.5 Kg/m2 and > 30 Kg/m2 were not included in the study. Locally advanced breast cancer, stage IIIB and stage IV were also excluded. Also, we excluded patients with breast size <300 cc and >700 cc.
The current study establishes a foundation to provide guidelines for preoperative surgical planning and intraoperative surgical decision to optimize post-operative results.
All surgical interventions were documented and analyzed regarding mean intraoperative time, weight of the LD muscle, volume of fat transfer and post operative volume reduction of the reconstructed breast. Donor site complications were followed up especially for signs seroma after drain removal.
Patient satisfaction about the shape and symmetry of the reconstructed breast, donor site scar, and overall satisfaction were noticed and compared between both groups using Modified KNUH Breast-Q.
This study showed that, the endoscopic Latissimus Dorsi (LD) muscle flap with fat graft can be brought together in a way to improve the aesthetic outcome and the overall patient satisfaction with less postoperative complications as the study indicates that postoperative donor site seroma and donor site scar are to be of lower incidence than the traditionally harvested Extended LD flap.