Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience...
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| Format: | Article |
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MDPI AG
2021-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/19/4515 |
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| author | Maximilian Mahrhofer Thomas Schoeller Maria Casari Kathrin Bachleitner Laurenz Weitgasser |
| author_facet | Maximilian Mahrhofer Thomas Schoeller Maria Casari Kathrin Bachleitner Laurenz Weitgasser |
| author_sort | Maximilian Mahrhofer |
| collection | DOAJ |
| description | Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data. |
| first_indexed | 2024-03-10T06:58:17Z |
| format | Article |
| id | doaj.art-c0d6661e2cbe46a8838dbcd5a538ab6d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T06:58:17Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c0d6661e2cbe46a8838dbcd5a538ab6d2023-11-22T16:20:41ZengMDPI AGJournal of Clinical Medicine2077-03832021-09-011019451510.3390/jcm10194515Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMIMaximilian Mahrhofer0Thomas Schoeller1Maria Casari2Kathrin Bachleitner3Laurenz Weitgasser4Department of Plastic and Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 70199 Tuebingen, GermanyDepartment of Plastic and Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 70199 Tuebingen, GermanyDepartment of Plastic and Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 70199 Tuebingen, GermanyDepartment of Plastic and Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 70199 Tuebingen, GermanyDepartment of Plastic and Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, 70199 Tuebingen, GermanyIntroduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data.https://www.mdpi.com/2077-0383/10/19/4515Poland syndromebreast reconstructiontransverse myocutaneous gracilisDIEPTMGTUG |
| spellingShingle | Maximilian Mahrhofer Thomas Schoeller Maria Casari Kathrin Bachleitner Laurenz Weitgasser Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI Journal of Clinical Medicine Poland syndrome breast reconstruction transverse myocutaneous gracilis DIEP TMG TUG |
| title | Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI |
| title_full | Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI |
| title_fullStr | Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI |
| title_full_unstemmed | Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI |
| title_short | Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI |
| title_sort | development of a surgical treatment algorithm for breast reconstruction in poland syndrome patients considering severity sex and bmi |
| topic | Poland syndrome breast reconstruction transverse myocutaneous gracilis DIEP TMG TUG |
| url | https://www.mdpi.com/2077-0383/10/19/4515 |
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