Abstract:
:Immediate breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM) flap after skin-sparing mastectomy is becoming an increasingly performed procedure in patients with ductal carcinoma in situ, early invasive breast cancer, and prophylactic mastectomy. Through a periareolar approach, it is possible to remove the breast parenchyma along with the nipple areola complex, preserving almost all the original skin envelope and the inframmamary fold. The TRAM flap is used to recreate the volume and shape of the original breast. This technique has higher quality and easier reconstruction. The major disadvantages, extensive scar and donor site skin color mismatch, are reduced to a minimum level because the former is limited at the natural border of the nipple areola and the latter can be effectively concealed with proper nipple reconstruction. Thirty-one patients with a mean age of 39 years (range, 26-50 years) who had undergone unilateral or bilateral mastectomy for early breast cancer and immediate breast reconstruction with the pedicled TRAM flap were retrospectively reviewed. Requirements for the skin-sparing mastectomy technique include suitability of donor site tissue for autologous tissue, early breast cancer or ductal carcinoma in situ, and adequate size and shape matching of the contralateral breast. There was no observed local recur- rence during the follow-up period (mean, 20 months; range, 11-30 months). Complications at the recipient site include mastectomy skin flap partial necrosis in 2 patients and cellulitis of the transferred flap in 1 patient. No total or partial flap necrosis was observed. One patient developed abdominal bulging 1 month after the operation, during the administration of chemotherapy. All reconstruction was considered very satisfactory from an aesthetic perspective by the surgeon and the patient. The nicer aesthetic result with oncological safety is achieved with immediate breast reconstruction with the TRAM flap after skin-sparing mastectomy. The risk of local recurrence is not higher compared with more radical surgical techniques.
journal_name
Int Surgjournal_title
International surgeryauthors
Gherardini G,Thomas R,Basoccu G,Zaccheddu R,Fortunato L,Cortino P,Evans GR,Matarasso A,D'Aiuto M,D'Aiuto Gkeywords:
subject
Has Abstractpub_date
2001-10-01 00:00:00pages
246-51issue
4eissn
0020-8868issn
2520-2456journal_volume
86pub_type
杂志文章abstract:OBJECTIVE:To compare the safety and effectiveness of laparosonic coagulating shears (LCS) and electrosurgery for use in laparoscopically assisted vaginal hysterectomy (LAVH). STUDY DESIGN:In this prospective study, patients undergoing LAVH performed by one of the authors from October 1997 to January 1998 were assigned...
journal_title:International surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2000-01-01 00:00:00
abstract::Endoscopic retrograde pancreatogram (ERP) has been recommended in patients with suspected pancreatic fistula to visualize the fistula tract and the ductal anatomy. Recently we have treated five men with chronic alcoholic pancreatitis complicated by pancreaticopleural or pancreaticoperitoneal fistula. The limited value...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::The authors consider 74 patients who have undergone reoperation for recurrent peptic ulceration in their hospital, between 1971 and 1980. Recurrences followed gastrectomy (39 cases), vagotomy (33 cases) and gastroenteroanastomosis (GEA) (2 cases). The reoperations were: vagotomy or revagotomy; gastric resection or rer...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::Tamoxifen (Nolvadex) has been in use for over 20 years and currently is probably the most prescribed anti-cancer medication in the world. It is an orally effective, synthetic, non-steroidal, estrogen antagonist and agonist agent. In studies and trials it has been shown to have only limited side effects. It has produce...
journal_title:International surgery
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
abstract::The authors performed a total of 237 endolaser treatments for insufficiency of great and small saphenous veins and assessed 5-year results. It was found that this method, especially if performed with a 1470-nm-wavelength laser combined with instrumental removal of some lateral veins, was very effective. It was delicat...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00
abstract::Proximal gastrectomy (PG) has been introduced for patients who are preoperatively diagnosed with early gastric cancer located in the upper third of the stomach. In the present study, we compared the prognosis of patients who underwent PG with that of patients who underwent total gastrectomy (TG). Between 1997 and 2006...
journal_title:International surgery
pub_type: 杂志文章
doi:10.9738/CC150.1
更新日期:2012-07-01 00:00:00
abstract::A case of carcinoid syndrome in a patient receiving treatment for a malignant non-B-cell tumor of the pancreas is presented, and a survival of >14 years is noted. The probable cause is discussed. The literature is reviewed. It was found that such a presentation is rare, and long-term survival in these cases exceedingl...
journal_title:International surgery
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract::This is a 1 year study on the use of a culdoscopic sterilization technique on 250 patients aged 25 or more with at least 4 children and at least 6 weeks Postpartum. Clinical examination was made to exclude tumors, infections, or endometriosis. The laparoscope was used for transvaginal female sterilization employing ...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1973-01-01 00:00:00
abstract::Obesity is an additional risk factor in surgical patients. The mortality rate in obese patients is high (3.6% in my series) and the morbidity is much higher. These patients may be prediabetic, diabetic, hypertensive or atherosclerotic and they are liable to develop postoperative coronary thromboses and chest complicat...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1985-04-01 00:00:00
abstract::Incidence of cholelithiasis in the teaching hospital population of India has been reported. The study suggests that North Indians are more prone to cholelithiasis than South Indians. Apparently this variation is related to dietary and geographical factors. ...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::Bronchobiliary fistula (BBF) is a rare condition which occurs most commonly as a complication of hydatid cyst liver disease. The following report describes a patient who presented with biliptysis 6 months following decortication of an empyema that had occurred following partial hepatectomy of a colon cancer metastasis...
journal_title:International surgery
pub_type: 杂志文章
doi:10.9738/INTSURG-D-13-00095.1
更新日期:2014-07-01 00:00:00
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journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2010-10-01 00:00:00
abstract::The natural course of biloma after laparoscopic cholecystectomy (LC) was successfully followed and evaluated by computed tomography (CT). Biloma is one of the major complications after LC. However, the processes of biloma progression and regression have not yet been reported in detail. We encountered a case of minor l...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract::Sixteen cases of acute pyogenic pericarditis have been reviewed. Uncontrollable septic course, episodes of cardiac tamponade and failure of the nonsurgical regimen were the main indications for surgery. Medical management is often ineffective because of the relentless septic course, presence of thick, viscid pus and g...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Intussusception is a rare cause of adult intestinal obstruction. Clinical manifestations are not specific, which makes a preoperative diagnosis difficult to establish and often causes delay. We report a case of acute intestinal obstruction due to ileocolic intussusception. An emergency laparoscopy was performed reveal...
journal_title:International surgery
pub_type: 杂志文章
doi:10.9738/INTSURG-D-12-00005.1
更新日期:2013-10-01 00:00:00
abstract::The first Spigelian hernia was described in 1764. From April 1995 to April 2004, 29 patients underwent 35 Spigelian hernia repair operations in our department. The choice of primary closure or additional mesh was based on the condition of the local tissue. If the tissue appeared of good quality, primary closure was pe...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2006-09-01 00:00:00
abstract::Persistent descending mesocolon is an uncommon developmental anomaly which results from failure of fusion of the descending mesocolon with the posterior parietal peritoneum. It is asymptomatic in most cases and rarely causes intestinal obstruction. We report here a case of primary intestinal obstruction complicated by...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract::We have analyzed 196 cases of pyloroduodenal obstruction due to peptic ulcer disease. Obstruction occurred in 19% of peptic ulcer patients. Males predominated five to one over females. Diagnosis could usually be made on clinical grounds alone. Air contrast x-ray studies were better than conventional barium meal x-rays...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1975-08-01 00:00:00
abstract::The goal of this study is to identify invariable risk factors predicting the morbidity and mortality of a serious complication of peptic ulcer perforation (PUP). One hundred fifty-four patients were operated for PUP. We selected 147 patients who underwent primary repair and omentoplasty for PUP. The Boey score used to...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2007-05-01 00:00:00
abstract::In a recent six-year-period, a total of 402 patients underwent parietal cell vagotomy (PCV) for duodenal ulcer. An overall clinical assessment by Visik grading placed 328 (82%) in grade I, 56 (14%) in grade II, 12 (3%) in grade III and 4 (1%) with recurrent ulcer in grade IV. Results of the gastric secretory tests sho...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1981-10-01 00:00:00
abstract::The infiltration of extrahepatic bile duct carcinoma along the bile duct wall was studied in 29 resection cases. Histologically, spreading took place by mucosal infiltration in one case, mucosal and transmural in three, and transmural in 25. The average microscopic infiltrating distance from the gross margin of the tu...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::For a better quality of life in rectal cancer patients, high dose radiotherapy following abdominoperineal resection of the rectum with a pelvic partition is another surgical option replacing extended abdominoperineal resection. In addition to pelvic partition with polyglycolic acid mesh, the tissue expander was insert...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Radiofrequency ablation of the liver for primary and metastatic disease is used for patients who are not candidates for resection or in conjunction with resection. The technique is simple, and the morbidity rate is low. A case of intrahepatic pseudoaneurysm after radiofrequency ablation of a centrally located hepatoce...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
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journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::During 1982-90 we changed the surgical treatment of acute necrotizing pancreatitis twice. The operative strategy consisted of early formal resection (n = 13) during 1982-84, early lavational surgery (n = 15) during 1985-87 and late necrosectomy (n = 17) during 1988-90. The mortality rate decreased from 54% to 40% and ...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::From April 1985 to March 1986 there were 48 cases of laser breast operations. Twelve cases of breast cancer were treated by modified radical mastectomy using a CO2 laser. Another twelve cases of breast cancer were treated conventionally using a scalped and electrocautery for the purpose of comparison. Laser surgery of...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::The aim of this study was to retrospectively evaluate the outcome of stapled, functional, end-to-end anastomosis (FEEA) for the reconstruction of right hemicolectomy. We enrolled 204 patients who underwent a right hemicolectomy for colon carcinomas or adenomas by open surgery. One hundred two patients received an FEEA...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2009-07-01 00:00:00
abstract::Operative stabilization of massive chest wall instability is described in 38 patients. 35 patients were young combat casualties with penetrating chest injuries operated upon at front hospitals with limited resources, two patients sustained automobile accidents with blunt thoracic trauma resulting in an extensive flial...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::To assess the possible role of truncal ligation of inferior thyroid arteries on post-thyroidectomy hypocalcemia, a prospective study was carried out on 80 patients. Bilateral subtotal thyroidectomy was performed for non-toxic nodular goiter in two groups. Inferior thyroid arteries were ligated bilaterally in 50 patien...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::An 89-year-old woman presented with a chief complaint of induration in the left breast persisting for 1 month. Core needle biopsy of the lesion showed invasive breast cancer. Therefore, we diagnosed the lesion as left breast cancer and performed a modified mastectomy. On the immunohistochemical study, the tumor was po...
journal_title:International surgery
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00