Reconstruction mammaire bilatérale par lambeau myocutanéograisseux de grand dorsal (31 cas consécutifs)

Abstract

Purpose of the study The purpose of this study was to analyse the advantages, disadvantages and results of bilateral breast reconstruction by autologous latissimus dorsi flap. Material and method Thirty-one two-stage consecutive bilateral breast reconstructions were performed by the same operator between 1993 and 2001. All the reconstructions, in immediate or delayed manner, were indicated after radical or skin sparing mastectomy for breast cancer. We used the autologous latissimus dorsi flap for all cases. The reconstruction of the second breast was always delayed of a few months to avoid back's complications. We reviewed the charts of these patients retrospectively. Preoperative datas, postoperative complications, dorsal seroma occurence, morphological results and patient's satisfaction were evaluated. Median follow-up was 22 months. Results The results confirm the procedure's reliability. Comparative rates of postoperative complications are not significantly different between first and controlateral breast reconstruction. Functional after-effects of bilateral latissimus dorsi harvesting are moderate. The aesthetics results have been judged as very good in 84% of cases and good in 16%. The satisfaction rate of the patients is high: 90,3% are pleased, 6,5% are satisfied and 3,2% are moderately satisfied. Conclusion The autologous latissimus dorsi flap allows a two-stage bilateral breast reconstruction. This procedure is not indicated for simultaneous bilateral breast reconstruction; it is the main drawback of this technique. So we believe that this procedure is an excellent alternative in all the indications of sequential bilateral breast reconstructions.