Local kiss flap for chest wall soft tissue reconstruction following mastectomy for locally advanced breast cancer
10.3760/cma.j.cn114453-20220725-00233
- VernacularTitle:局部kiss皮瓣在局部晚期乳腺癌术后胸壁软组织缺损修复中的初步应用
- Author:
Bingjian XUE
1
;
Xinxing WANG
;
Kaiqiang LI
;
Junyuan XIE
;
Li GAN
;
Xinhong PEI
Author Information
1. 郑州大学第一附属医院乳腺外科，郑州 450052
- Keywords:
Surgical flaps;
Breast neoplasms;
Kiss flap;
Thoracic wall soft-tissue defect;
Reconstructive surgical procedures
- From:
Chinese Journal of Plastic Surgery
2023;39(4):359-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate preliminary results of chest wall reconstruction with local kiss flap following mastectomy for locally advanced breast cancer (LABC).Methods:Clinical data of the LABC patients receiving treatment at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between June 2020 and July 2021 was retrospectively analyzed. All patients underwent modified radical mastectomy after neoadjuvant chemotherapy. And the local kiss flap was used for reconstruction of the secondary chest wall soft tissue defects. Two small local flaps were designed intraoperatively and harvested from inferior (flap A) and lateral (flap B) to the defect, respectively, resurfacing a large chest wall soft tissue defect side by side with primary closure of both two donor sites. The flap perfusion was routinely monitored postoperatively. Adjuvant systemic therapies were implemented based on both pre- and post-operative pathological results. And the adjuvant radiotherapy was started immediately after wound healed completely. All cases were followed up regularly.Results:A total of five female patients were included, with an average age of 53.4 (ranging from 41 to 71). Stage Ⅲ (T 3-4N 2-3M 0) breast cancer was diagnosed in all cases. After mastectomy, chest wall soft tissue defect was presented in all cases, ranging from 12.0 cm × 12.0 cm to 22.0 cm × 20.0 cm. The flap A measured from 7.0 cm × 7.0 cm to 14.0 cm × 13.0 cm and the flap B from 5.0 cm × 4.0 cm to 11.0 cm × 7.0 cm. Only 1 flap A suffered tip necrosis and the remnant flaps survived totally. All donor sites recovered uneventfully and no donor-site morbidity was noted. The mean post-operative follow-up period was 15.8 months (ranging from 13 to 20 months). No tumor recurrence or metastasis was noted in all patients, except one patient, who did not receive radiotherapy, suffered local recurrence 4 months after surgery. Conclusion:Given its simplicity and satisfying results, the local kiss flap is a feasible and reliable reconstructive option for chest wall soft tissue defect reconstruction after mastectomy in selected LABC patients.
