Kim, Jae Bong; Eom,
Jeung Ryeol; Lee, Jeong Woo; Lee, Jeeyeon; Park, Ho Yong; Yang, Jung Dug
Background:
Immediate partial breast reconstruction after breast-conserving surgery has
become a new paradigm in treating breast cancer. Among the volume replacement
techniques used for small to moderate-sized breasts, the perforator flap method
has many advantages. The authors present anatomical studies and two surgical
techniques using lateral intercostal artery perforator flaps. Methods: Data from 40 patients who
underwent breast reconstruction using the lateral intercostal artery perforator
flap between January of 2011 and June of 2016 were included. The authors
conducted comparative analyses of the propeller flap and the turnover flap.
They used three-dimensional computed tomography in lateral intercostal artery
perforator flap anatomical studies, analyzing the distribution probability of
the dominant perforator, the vertical distance from the axillary fold, and the
horizontal distance from the anterior border of the latissimus dorsi.
Results: The
most dominant perforator used for lateral intercostal artery perforator flaps
was the sixth lateral intercostal artery perforator (43.6 percent of cases),
followed by the seventh lateral intercostal artery perforator (39.1 percent of
cases); their mean distances from the latissimus dorsi and the axillary folds
were determined and reported. Complications included three cases requiring
additional treatment for fat necrosis (propeller method, two cases; turnover
method, one case) and venous congestion in only two cases that used the
propeller method. Cosmetic satisfaction was 90 percent or greater for both
techniques, indicating that results were rated as either excellent or good. Conclusion: The authors believe that
their study results can broaden the application of partial breast
reconstruction by using the lateral intercostal artery perforator flap after
breast-conserving surgery, with three-dimensional computed tomography for
anatomical studies, and using one of the authors’ two described surgical
techniques. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
