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The Use Of Latissimus Dorsi Muscle And Musculocutaneous Flaps After Treatment Of Breast Cancer

Background: A latissimus dorsi flap technique is selected when additional tissue is needed to rebuild mastectomy defects and the TRAM flap is not available or other reasons prevent its use. The latissimus dorsi flap is also useful to supplement the skin at the mastectomy site and to provide additional muscle cover for an implant or expander when the reconstructed breast needs to be fuller and more ptotic or when the other breast is to be matched at the time of an immediate breast reconstruction. A latissimus dorsi flap provides implant cover so that the reconstructed breast has a more natural appearance. The aim of this work was to evaluate the efficacy of latissimus dorsi muscle and musculocutaneous flap in reconstruction of breast after treatment of breast cancer as regard cosmetic outcome, complications, patient satisfaction after reconstruction. Methods: This case-control study was carried out at the General Surgery Department in Benha University Hospital, was conducted on 20 female patients with breast cancer which had surgical treatment and need reconstruction. Any female patient presented with breast cancer in our study was taken regarding complete history, complete clinical examination and investigations (mammogram, breast and axillary u/s, biopsy (FNAB) and MRI of breast when indicated). This study was done from April 2019 to March 2022. Results: Regarding operative data, operative time ranged from 175 to 300 minutes with mean 233.75 minutes. Blood loss ranged from 150 to 220 ml with 188 ml. Regarding scar formation, three patients (15%) had unsatisfactory scar formation. Regarding complications, four patients had seroma (20%) and cellulitis occurred in 5%. None of the patients suffered infection, recurrence or keloid formation at the surgical site. We attribute the low number of seroma cases to quick elevation of myocutaneous flap and quick closure of the donor site, as well as tensionless closure of the donor site. All our studied patients had preserved axillary bulge. Conclusion: Latissimus dorsi myocutaneous flap plus musculocutaneous flaps is an extremely safe and reliable option for breast reconstruction. It is a simple technique with fewer complications than other reconstructive techniques, particularly for patients who fear postoperative complications and who wish to return to normal life.