The extended latissimus dorsi flap in oncology breast reconstruction: Case report and literature review

Abstract

The latissimus dorsi myocutaneous flap was one of the first methods of oncology breast reconstruction described. However, the standard latissimus dorsi flap alone often does not provide sufficient volume for breast reconstruction, it may have not been the first choice any more. The design of an extended latissimus dorsi flap has involved to include the parascapular and scapula fat fascia in addition to the lumbar fat for additional volume. The main advantage of the extended latissimus dorsi flap is that it can provide autogenous tissue to restore breast volume, it is suitable for Asian women whose breasts are not too large. The author reported the first case of breast reconstruction after mastectomy using the extended latissimus dorsi flap at Viet Duc University Hospital with 5-year follow up and literature review.

Keywords: Extended latissimus flap, breast reconstruction, breast cancer.

References

1. Casellas-Grau A, Vives J, Font A, Ochoa C. Positive psychological functioning in breast cancer: An integrative review. 2016 Jun;27:136-68. Epub 2016 Apr 23.
2. Tran Viet The Phuong, Tran Van Thiep, Truong Van Truong et al. Immediate reconstruction with latissimus dorsi flap in breast cancer treatment at Ho Chi Minh City Oncology Hospital –Technique and oncological results. Y hoc. TP Ho Chi Minh, 2010, Vol. 14, supplement of No. 4, 422-432.
3. Teisch LF, Gerth DJ, Tashiro J, Golpanian S, Thaller SR. Latissimus dorsi flap versus pedicled transverse rectus abdominis myocutaneous breast reconstruction: outcomes. J Surg Res. 2015 Nov;199(1):274-9. Epub 2015 Apr 8.
4. Sood R, Easow JM, Konopka G, Panthaki ZJ. Latissimus Dorsi Flap in Breast Reconstruction: Recent Innovations in the Workhorse Flap. Cancer Control. 2018;25(1):1-7.
5. Chang DW, Youssef A, Cha S, Reece GP. Autologous breast reconstruction with the extended latissimus dorsi flap. Plast Reconstr Surg. 2002 Sep 1;110(3):751-9
6. Garusi C, Lohsiriwat V , Brenelli F, et al. The value of latissimus dorsi flap with implant reconstruction for total mastectomy after conservative breast cancer surgery recurrence. 2011;20:141–144.
7. Kiiski J, Kaartinen I, Kotaluoto S, and Kuokkanen H. Modified approach for endoscopic harvest of the latissimus dorsi free flap with CO₂insufflation and standard laparoscopic equipment. 2017;37:383–387.
8. Kokosis G, Nima Khavanin N, Nahabedian MY. Latissimus Dorsi Musculocutaneous Flap for Complex Breast Reconstruction: Indications, Outcomes and a Proposed Algorithm. Plast Reconstr Surg Glob Open. 2019;7:e2382