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The axillary versus internal mammary recipient vessel sites for breast reconstruction with diep flaps: A retrospective study of 256 consecutive cases
Author(s) -
Santanelli Fabio,
Longo Benedetto,
Sorotos Michail,
Pagi Marco,
Laporta Rosaria
Publication year - 2015
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22266
Subject(s) - medicine , breast reconstruction , diep flap , anastomosis , surgery , axillary vein , vein , circumflex , dissection (medical) , retrospective cohort study , umbilicus (mollusc) , mastectomy , breast cancer , thrombosis , cancer , artery
The aim of this study is to present our experience on the use of various recipient sites for deep inferior epigastric perforator (DIEP) flap breast reconstruction and compare them by means of objective data. Two hundred fifty six DIEP flap breast reconstructions, performed between March 2004 and May 2011, were retrospectively analyzed. Only unilateral reconstructions were included in the study and divided into three groups depending on the recipient site choice: internal mammary vessels (IMV) ( n = 52), thoracodorsal vessels (TDV) ( n = 109), and circumflex scapular vessels (CSV) ( n = 95). Clinical records of each patient were reviewed to acquire relevant data such as operative time, postoperative complications, and use of a second vein anastomosis. CSV group showed a statistically significant lower operative time (4.92 ± 0.54 hours) compared to TDV (5.67 ± 1.01 hours) and IMV groups (6.75 ± 1.09 hours) ( P < 0.001). Second vein anastomosis was performed in 84 cases (88.1%) of CSV, in 85 cases (77.9%) of TDV, and in 18 cases (35.1%) of IMV groups ( P < 0.001). No significant differences were observed among groups regarding risk factors and complications ( P > 0.05). The axillary vessels seem to be the ideal recipient site because of reduced operative time and increased possibility to perform a second vein anastomosis. Among them, CSV can be safely used due to following advantages: easy dissection, larger vessel caliber, and optimal flap insetting. Moreover, their location does not expose them completely to radiotherapy consequences. © 2014 Wiley Periodicals, Inc. Microsurgery 35:34–38, 2015.