title: Laparoscopic bilateral salpingo-oophorectomy in breast cancer patients after transverse rectus abdominus myocutaneous flap reconstructive surgery.
abstract: OBJECTIVE
  The aim of this study was to describe the feasibility and outcome of laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in patients with a history of breast cancer who previously had undergone a transverse rectus abdominus myocutaneous (TRAM) flap reconstruction.
  
  
  METHODS
  We performed a retrospective review of patients with a history of breast cancer who had undergone laparoscopic RRSO between February 1995 and April 2002. Patients who had undergone TRAM flap reconstructive surgery were compared with patients who had undergone laparoscopic RRSO without prior reconstructive surgery.
  
  
  RESULTS
  We identified 102 patients with a history of breast cancer who were candidates for a laparoscopic RRSO during the study period. One hundred one of these patients underwent the procedure, including 10 patients with a history of TRAM flap breast reconstructive surgery. One patient did not undergo the procedure because she was noted to be hypotensive prior to the procedure from her bowel preparation. There were no differences between the groups with or without prior history of TRAM flap reconstruction with respect to body mass index, prior abdominal surgery, menopausal status, or preoperative ultrasound characteristics. Operatively, there was no difference between the groups with respect to estimated blood loss, hospital stay, and intraoperative and postoperative complication rates. The only noted difference between the two groups was the estimated operating time (TRAM group, 91 min; non-TRAM group, 70 min [P<0.01]).
  
  
  CONCLUSIONS
  Laparoscopic RRSO is safe and feasible in patients who have undergone a prior TRAM flap reconstruction.
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Awtrey
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Disa
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Ivy
authors.forename: Noah D
authors.initials: ND
authors.lastname: Kauff
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Hummer
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000517:prevention & control*; D010052:Ovariectomy / Q000379:methods*; D017568:Rectus Abdominis / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps