Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Systematic Review of Patient-Reported Outcomes and Complications of Pedicled Latissimus Flap Breast Reconstruction

  • Emanuela C. Peshel (Division of General Surgery, Beaumont Health System) ;
  • Claire M. McNary (Department of Surgery, Oakland University William Beaumont School of Medicine) ;
  • Catherine Barkach (Department of Surgery, Oakland University William Beaumont School of Medicine) ;
  • Elizabeth M. Boudiab (Division of General Surgery, Beaumont Health System) ;
  • Daniella Vega (Division of Plastic and Reconstructive Surgery, Beaumont Health System) ;
  • Farid Nossoni (Division of Plastic and Reconstructive Surgery, Beaumont Health System) ;
  • Kongkrit Chaiyasate (Department of Surgery, Oakland University William Beaumont School of Medicine) ;
  • Jeremy M. Powers (Division of Plastic and Reconstructive Surgery, Department of Surgery, Quillen College of Medicine, East Tennessee State University)
  • Received : 2022.04.14
  • Accepted : 2023.02.15
  • Published : 2023.07.15
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Abstract

The latissimus dorsi (LD) flap is a reliable option for breast reconstruction. This is particularly true in patients with contraindications to abdominally based autologous breast reconstruction. A systematic review of patient satisfaction and health related quality of life following LD breast reconstruction using the BREAST-Q survey was conducted. The scope of the review was to determine the degree of patient satisfaction following the procedure and to examine how patient satisfaction from the pedicled LD flap compares to other breast reconstructive procedures. A literature search on BREAST-Q in LD flap reconstruction was performed. Only articles written in English and in published peer-reviewed journals were included. Studies with less than 20 patients in their sample and those with a follow-up period of less than 1 year were excluded. Five articles representing 331 patients were reviewed, including one case-control study and four retrospective cohort studies. Level of evidence was either III (4) or IV (1). The average age was 53 with average body mass index of 25. Most reconstructions were delayed (67%) and unilateral (88%), and most patients required radiation (79%). The average length of follow-up was 36 months, and the response rate was 75%. Overall, patients who underwent LD flap reconstruction reported favorable outcomes in satisfaction domains and quality of life domains with few complications. A meta-analysis also demonstrated higher satisfaction in LD flap without implants compared with LD flap with implants. Patient-reported outcomes following LD breast reconstruction compare favorably with other techniques of breast reconstruction.

Keywords

Acknowledgement

We thank the Oakland University William Beaumont Medical library staff, especially associate professor of Information Literacy in the Department of Foundational Medical Studies and eLearning Librarian Stephanie Swanberg. We hope that this will serve surgeons to better counsel patient in regard to patient satisfaction after LD flap breast reconstruction.

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