Role of Ti-loop patch in shaping immediate omental breast reconstruction after breast cancer surgery
10.3760/cma.j.cn115807-20230724-00019
- VernacularTitle:Ti-loop补片在乳腺癌术后大网膜一期乳房重建中的作用
- Author:
Junda HU
1
;
Li LI
;
Hao LIU
;
Nengbin WAN
;
Qi LIU
;
Fen TANG
;
Youben FAN
;
Lingli LU
Author Information
1. 上海交通大学医学院附属第六人民医院甲乳疝外科，上海 200233
- Publication Type:Journal Article
- Keywords:
Breast reconstruction;
Greater omentum;
Breast cancer;
Laparoscopy;
Ti-loop patch
- From:
Chinese Journal of Endocrine Surgery
2025;19(2):141-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the technical difficulties, key points and cosmetic effects of Ti-loop patch application in breast shaping of immediate reconstruction with omental flap transplantation after mastectomy.Methods:The clinical data of 90 cases with breast cancer who underwent immediate breast reconstruction by using laparoscopically harvested omental flap alone or combined with prosthesis after nipple and areola complex sparing mastectomy from May. 2020 to Jan. 2023 in Hunan Cancer Hospital was retrospectively analyzed. All patients were female between 16 and 55 years old with the average age of 42. Their courses of the disease range from 5 to 26 months with the mean of 15.5 months. These patients received mastectomy with conservation of nipple and areola, and then the greater omentum with right pedicle were harvested laparoscopically. Ti-loop patch was used to hang and fix the greater omentum as a support. 27 patients accepted immediate breast reconstruction with pedicled greater omentum alone, while 63 subjects with greater omentum and gel prosthesis. Among them, contralateral breast contraction and lift was operated on 9 cases.Results:All the pedicled greater omentum successfully survived, and wound surfaces of donor and recipient sites healed at stage I. Axillary lymph node dissection and postoperative radiotherapy were performed on 14 patients with positive pathological examination of sentinel lymph nodes. Breasts of two patients were found to be smaller after postoperative radiotherapy. All 90 subjects were followed up for 5 to 32 months, and the average follow-up period was 16.4 months. The reconstructed breasts were good in shape and tactile sensation. Only punctate scars were observed in donor sites of abdomen. All patients recovered with no upper limb lymphedema, no short and long term complications in abdomen, and only one patient had papillary recurrence without distant metastasis.Conclusions:The omental flap is hard to be sutured and shaped in the reconstructed breast, while easily to be avulsed and form hematoma. The application of Ti-loop patch, which could semi-surround and wrap the greater omentum, and suspend and fix it on the chest wall in upper pole of the breast as a support, can significantly improve the reconstruction effect.
