Thoracoabdominal Flap: a Simple Flap for Covering Large Post-mastectomy Soft Tissue Defects in Locally Advanced Breast Cancer

We present our experience of TA flap cover for large post-mastectomy defect s. A retrospective analysis of prospectively maintained breast cancer database in the Department of Surgical Oncology from January 1994 to December 2017 at All India Institute of Medical Sciences, New Delhi, was performed. The medical records of patients undergoing TA flap cover were analyzed to ass ess operative duration, blood loss, post-operative morbidity, hospital stay, adjuvant treatment, recurrence patterns, and survival outcome. A total of 3142 breast cancer patients underwent surgery, of which 1840 were LABC and 88 patients (4.13%) of LABC required flap cover for the closure of mastect omy defect. TA flap was used in majority of these patients 72/83 (86.7%) for cover. Majority was stage IIIB (54 out of 72) and we could achieveR0 resection in all patients. TA flap was done following MRM in 60 patients and RM in 12 patients. Upfront primary surgery was performed in 27 patients and 4 5 underwent surgery after neoadjuvant chemotherapy. Most commonly laterally based flaps were done, except 4 medially based flaps. The mean operating time was 30 min and blood loss was 45 ml. Mean hospital stay was 4.45 days. Superficial flap necrosis occurred in 6 and wound infection in 4 patient s, all managed conservatively. Only 2 patients had major flap loss and required debridement and skin grafting. Planned post-operative radiation could be delivered in most of the patients in time. At a mean follow-up of 2...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research