Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction
Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast recon...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2012-07-01
|
| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.4.376 |
| _version_ | 1798032538249199616 |
|---|---|
| author | Taik Jong Lee Wu Jin Hur Eun Key Kim Sei Hyun Ahn |
| author_facet | Taik Jong Lee Wu Jin Hur Eun Key Kim Sei Hyun Ahn |
| author_sort | Taik Jong Lee |
| collection | DOAJ |
| description | Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction.
Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed.
Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276).
Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained. |
| first_indexed | 2024-04-11T20:15:39Z |
| format | Article |
| id | doaj.art-279a624cbb6c4e20803a4b5e56125ce7 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-11T20:15:39Z |
| publishDate | 2012-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-279a624cbb6c4e20803a4b5e56125ce72022-12-22T04:04:59ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712012-07-01390437638310.5999/aps.2012.39.4.376Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast ReconstructionTaik Jong Lee0Wu Jin Hur1Eun Key Kim2Sei Hyun Ahn3Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.4.376breast neoplasmsmammaplastyneoplasm recurrence, local |
| spellingShingle | Taik Jong Lee Wu Jin Hur Eun Key Kim Sei Hyun Ahn Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction Archives of Plastic Surgery breast neoplasms mammaplasty neoplasm recurrence, local |
| title | Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction |
| title_full | Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction |
| title_fullStr | Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction |
| title_full_unstemmed | Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction |
| title_short | Outcome of Management of Local Recurrence after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction |
| title_sort | outcome of management of local recurrence after immediate transverse rectus abdominis myocutaneous flap breast reconstruction |
| topic | breast neoplasms mammaplasty neoplasm recurrence, local |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2012.39.4.376 |
| work_keys_str_mv | AT taikjonglee outcomeofmanagementoflocalrecurrenceafterimmediatetransverserectusabdominismyocutaneousflapbreastreconstruction AT wujinhur outcomeofmanagementoflocalrecurrenceafterimmediatetransverserectusabdominismyocutaneousflapbreastreconstruction AT eunkeykim outcomeofmanagementoflocalrecurrenceafterimmediatetransverserectusabdominismyocutaneousflapbreastreconstruction AT seihyunahn outcomeofmanagementoflocalrecurrenceafterimmediatetransverserectusabdominismyocutaneousflapbreastreconstruction |