Abstract:
:Transverse rectus abdominis musculocutaneous (TRAM) breast reconstruction in patients with advanced breast cancer is controversial. Management of these patients is often complex and consists of surgical extirpation, postoperative radiation, chemotherapy, and in some cases bone marrow transplantation. Few studies have attempted to examine patient long-term survival and overall satisfaction with the surgical procedure. This study examines one center's experience with patients undergoing breast reconstruction for stage III and stage IV breast carcinoma. A retrospective review was performed of all patients undergoing TRAM reconstruction with stage III or IV breast cancer. Surviving patients and family members were contacted for follow-up. Patients were asked to grade their satisfaction with the reconstructive procedure on a 5-point scale (5 points, extremely satisfied; 1 point, extremely dissatisfied). Postoperative complications and time to return to work were also recorded. During a 10-year period (1991-2000) 21 women underwent TRAM reconstruction for advanced breast cancer. Twenty patients had stage III disease and 1 patient had stage IV disease. Mean patient age was 49 years. A total of 26 TRAM flaps were performed; 5 patients had bilateral procedures. Of the 26 TRAM flaps, 17 were immediate and 9 were delayed, and 20 were free and 6 were pedicled. Follow-up averaged 6.5 years (range, 2-10 years). Postoperative complications occurred in 7 patients and included fat necrosis (N = 3), hematoma (N = 2), cellulitis (N = 1), delayed donor site healing (N = 2), and seroma (N = 1). There were no flap losses. Patients were able to return to normal activities or work at an average of 10.6 weeks. Eleven patients developed recurrent disease. Nine patients (43%) succumbed to their disease during the follow-up period. In these patients the average interval between TRAM reconstruction and death was 3.7 years (range, 1-6.5 years). Eleven patients or surviving family members participated in the patient satisfaction survey. The average satisfaction grade was 4.6 points. All patients would repeat the TRAM reconstruction again. Patients with advanced breast cancer can be considered appropriate candidates for TRAM reconstruction. The results of this study indicate that patients with advanced breast cancer do not have an increased rate of postoperative complications, and they recover within a reasonable time from their surgical procedure despite adjuvant radiation and chemotherapy. Furthermore, the majority of patients are satisfied with their reconstructed breast and postoperative course, and would choose this reconstructive option again.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Behnam AB,Nguyen D,Moran SL,Serletti JMdoi
10.1097/01.SAP.0000069075.27321.BCsubject
Has Abstractpub_date
2003-06-01 00:00:00pages
567-71issue
6eissn
0148-7043issn
1536-3708journal_volume
50pub_type
杂志文章abstract::This study documents that reduction mammoplasty is a procedure with excellent long-term patient satisfaction. This has not been previously well documented. One hundred nine patients after reduction mammoplasty were surveyed by questionnaire. Results of the questionnaire indicated that the majority of patients were ple...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199204000-00011
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:The earlobe plays an important part in the aesthetic appearance of the auricle. Congenital cleft earlobe may vary considerably in severity from a simple notching to extensive tissue deficiency. Most patients with cleft earlobe require surgical correction because of abnormal appearance. In this article, a new...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31824144a7
更新日期:2013-06-01 00:00:00
abstract::Fat necrosis in transverse rectus abdominis musculocutaneous (TRAM) flap is considered to be mainly affected by blood supply. This prospective study compares the incidence of fat necrosis between zones II and III in 400 consecutive patients who had undergone unipedicled TRAM flap breast reconstruction. Fifty-eight pat...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.sap.0000252770.15946.14
更新日期:2007-09-01 00:00:00
abstract::Early complications following aortofemoral bypass grafting include acute limb ischemia, renal failure, bowel and spinal cord ischemia, and myocardial infarction. Although the literature recognizes these more common complications, we have found very few reports that raised the possibility of an anatomically determined,...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199612000-00014
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:Post-burn cicatricle contractures of neck pose a challenge for plastic and reconstructive surgeons. To improve functional and cosmetic results, and to minimize the donor-site morbidity, we use pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a feasible choice for resur...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000245
更新日期:2014-09-01 00:00:00
abstract::The surgical treatments for prominent ears are on the basis of the approach over the basics of the deformity decrease the concha-mastoid angle and create a new antihelical fold. The author describes a new retroauricular flap to be used in the recreation of the antihelical fold and critically analyzes the cosmetic resu...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318195bfdd
更新日期:2009-11-01 00:00:00
abstract::We present a case of a nail defect, which was reconstructed by free composite nail combined with the palmar pocket method without vascular anastomoses. A 40-year-old man lost his nail of the right middle finger by trauma 1 year ago. A total nail composite graft, composed of germinal and sterile matrices, and proximal ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164731.99795.fe
更新日期:2005-06-01 00:00:00
abstract::Nine patients with symptomatic macroglossia, 3 with Beckwith-Wiedemann syndrome, 3 with Down's syndrome, and 3 with lymphatic malformation of the tongue, were evaluated for postoperative improvement following partial glossectomy. Symptoms evaluated were speech intelligibility, oral competence at rest, drooling, and no...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199007000-00003
更新日期:1990-07-01 00:00:00
abstract::Dorsal hump reduction almost always breaks the internal nasal valve and nasal obstruction is likely to occur postoperatively, unless reconstructed. One hundred eighty patients were operated using both open and closed rhinoplasty approaches. Upper lateral cartilages were meticulously separated from their junction with ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31816dd359
更新日期:2008-11-01 00:00:00
abstract::The arcuate line is a relevant structure when reconstructing the abdominal wall after rectus abdominis musculocutaneous flap harvest. Its location is classically taught to be half the distance from the pubic symphysis to the umbilicus, but recent anatomic literature provides evidence to the contrary. Better understand...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000112285.44287.21
更新日期:2004-08-01 00:00:00
abstract::Thirty cases of constriction band syndrome diagnosed and treated with surgery at Ramathibodi Hospital, Bangkok, during 1973 to 1986 are reported. The incidence of this congenital anomaly could not be verified in this series because the number of cases was limited and the cause could not be concluded. The less frequent...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198811000-00017
更新日期:1988-11-01 00:00:00
abstract::Our study of experimental contracture in rats confirms the existence in laboratory animals of a phenomenon very much like human capsule contracture. The ultrastructural features of capsules in rats are essentially identical to those for humans and rabbits. Macrophages with silicon-containing material were present. Sta...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198103000-00003
更新日期:1981-03-01 00:00:00
abstract::During this experiment the authors investigated whether prolonged local use of verapamil or lidocaine prevents vasoconstriction and establishes better blood supply to the rat epigastric skin flap, hence reducing the necrosis that occurs otherwise. Abdominal wall skin flaps of 45 Sprague-Dawley rats, based on a single ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199909000-00010
更新日期:1999-09-01 00:00:00
abstract::Ischemia/reperfusion injury (IRI) after free tissue transfer of the small intestine results in transmural tissue damage. This study examined the effects of IRI on the jejunum. Wistar rats served either as controls (N=10) or underwent clamping of the infrarenal aorta for 1 hour followed by 1 hour of reperfusion (N=10)....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199806000-00008
更新日期:1998-06-01 00:00:00
abstract::We report 2 patients with paraspinous sarcoma treated with omental transposition tunneled through a defect in the lumbar fascia that resurfaced in the soft tissues of the lower back. Traditional reconstruction with skin flaps was unsatisfactory because of prior irradiation to the area. In 1 patient the omentum obliter...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199312000-00015
更新日期:1993-12-01 00:00:00
abstract::Aim of this study is to describe the use of high-frequency ultrasound to ascertain the site, quantity, and type of filler injected in the soft tissue of the face, with respect to reliability of the procedure and the analysis costs. Between December 2006 and August 2010, 80 subjects aged 25 to 65 years, who underwent f...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318203ebf6
更新日期:2011-11-01 00:00:00
abstract::Tight abdominal closures, as can be seen during transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction, have been shown to increase intra-abdominal pressure, thereby decreasing thoracopulmonary compliance and increasing the workload of breathing. The purpose of this article was to quantitate pu...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000000310
更新日期:2016-01-01 00:00:00
abstract::The morphology of macrostomia and a method of myoplasty and commissuroplasty are described. The important operative considerations are accurate commissure positioning, muscle reconstruction, obliteration of the lateral subdermal groove, placement of a vermilion flap across the commissure, and Z-plasty of skin in the n...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198108000-00010
更新日期:1981-08-01 00:00:00
abstract::Internal and external diameters of sections of radial and ulnar arteries obtained from fresh cadavers were measured. Statistical analysis of the results obtained shows significant correlation (p less than 0.05). The wide range of values obtained suggests that, despite this degree of correlation, the internal diameter ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198709000-00006
更新日期:1987-09-01 00:00:00
abstract::We describe here 2 patients with question mark ears in one family. They had the peculiar auricular deformities bilaterally. Both patients had a cleft between the helix and earlobe respectively. The upper portion of the auricle showed marked prominence. The mother also showed notching between the helix and earlobe. The...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-198901000-00013
更新日期:1989-01-01 00:00:00
abstract::A comparison study of donor site care using 5 common modalities was undertaken. A total of 210 treated donor areas were examined for healing differences, comfort, complications, and cost. At the conclusion of the study we were able to recommend certain treatment methods depending on the nature of the donor wound. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198009000-00013
更新日期:1980-09-01 00:00:00
abstract:BACKGROUND:Scalp melanoma is aggressive and has a proclivity for regional metastasis. We hypothesize that subperiosteal scalp melanoma resection reduces in-transit/satellite recurrence, when compared with subgaleal resection. METHODS:We identified patients with intermediate to deep, primary scalp melanoma referred to ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822592e7
更新日期:2012-08-01 00:00:00
abstract::The high number of reconstructive dilemmas brought about by more aggressive treatment of congenital malformations and burns has created the need for large quantities of donor skin for local coverage. Tissue expansion with external ports has become part of the authors' surgical armamentarium. From January 1996 to Novem...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200044010-00003
更新日期:2000-01-01 00:00:00
abstract::Loss of pinch power associated with loss of coordinated movement of thumb and index fingers is the major disability in patients with ulnar nerve paralysis. Several tendon transfer methods utilizing different donor muscles have been used to restore adductor pollicis muscle function in ulnar nerve paralysis. In this pap...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000209028.11153.be
更新日期:2006-07-01 00:00:00
abstract::A technique of correction of Stahl's ear is presented and is compared with other techniques reported in the literature. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000067728.84041.96
更新日期:2004-01-01 00:00:00
abstract::A large cutaneous horn was excised from the left side of the nose and cheek of a 68-year-old woman. Reconstruction was performed with a split-thickness skin graft. Histologically the lesion represented squamous cell carcinoma. The nature of malignant degeneration in cutaneous horns is discussed. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199712000-00019
更新日期:1997-12-01 00:00:00
abstract::Tissue engineering has largely focused on single tissue-type reconstruction (such as bone); however, the basic unit of healing in any clinically relevant scenario is a compound tissue type (such as bone, periosteum, and skin). Nanofibers are submicron fibrils that mimic the extracellular matrix, promoting cellular adh...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31818e48bf
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND AIM:To date, clinically relevant selection criteria have not been established for the use of the gluteal fold flap after oncological vulvoperineal resection. We prospectively assessed the surgical risk factors of this reconstructive technique in a large series. METHODOLOGY:From April of 2000 through Dec...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000964
更新日期:2017-07-01 00:00:00
abstract::Twenty patients with capillary/cavernous hemangiomas of the periorbital area (eyelid, eyebrow, nose extending to canthus) have been treated with a variety of techniques. Six patients were treated by yttrium-aluminum-garnet (YAG) laser photocoagulation and direct injection of steroids. Rapid shrinkage of the hemangioma...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199005000-00002
更新日期:1990-05-01 00:00:00
abstract::Upper thoracic wounds with exposed hardware from spinal instrumentation and previous radiation presents a subset of back wound coverage problems that lend themselves to a unique opportunity to use the distal trapezius musculocutaneous flap. The unradiated, healthy skin paddle can be transposed between the radiated ski...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000054242.00928.06
更新日期:2003-07-01 00:00:00