[Minimally invasive breast surgery. Breast reconstruction using pure muscular latissimus dorsi flap].
BACKGROUND
Minimally invasive surgical techniques have extended to all the fields of surgery. Breast surgery can also benefit from these concepts because of their special characteristics, reduction of aggressiveness, avoiding or hiding scars. The aim of our work is to introduce a new surgical approach for the resection of a large volume of breast parenchyma, including complete subcutaneous mastectomy and reconstruction using a pure muscular latissimus dorsi flap, with or without prosthetic material, through a minimal cutaneous incision.


METHODS
Retrospective analysis of our series of 5 cases using our surgical technique which allows us to establish proper indications. We analyse the technical details, complications and results.


RESULTS
Five patients were operated using this technique (1 giant hamartoma, 1 multicentred in situ carcinoma with Paget's disease, 1 multicentred infiltrating carcinoma and 2 malignant tumours arising in the external part of the breast). We performed oncological resections (2 partial resections and 3 complete subcutaneous mastectomies) including sentinel lymph node biopsy or total axillary lymphadenectomy. After a mean follow-up of 10 months no local relapses were found and the cosmetic results were excellent.


CONCLUSIONS
Minimally invasive surgical techniques through a posterior axillary line vertical incision enable total or partial subcutaneous mastectomy and a breast reconstruction, using muscular flaps or prosthetic material, to be performed.
Güemes
Antonio
A
Servicio de Cirugía A. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España. aguemes@unizar.es
Sousa
Ramón
R
Cachón
Ruth
R
Valcarreres
Pilar
P
Rufas
María
M
Gonzalo
Azucena
A
Gil
Ismael
I
Lozano
Ricardo
R
D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002278:Carcinoma in Situ / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D003358:Cosmetics; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006222:Hamartoma / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D016462:Mammaplasty / Q000379:methods*; D008327:Mammography; D015414:Mastectomy, Subcutaneous; D019060:Minimally Invasive Surgical Procedures; D010144:Paget's Disease, Mammary / Q000601:surgery*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome
D003358:Cosmetics