title: [Color doppler ultrasound evaluation of thoracodorsal pedicle quality after axillary lymph node dissection. A way to increase latissimus dorsi flap reliability: about 74 patients].
abstract: The latissimus dorsi musculocutaneous flap has been widely used for breast reconstruction. It is a reliable method with low complications. Thoracodorsal pedicle is constant but might have been dissected and injured previously, for example, in case of axillary lymph node dissection. The purpose of our study is to assess the benefit of systematic preoperative echo-doppler imaging of the thoracodorsal pedicle. Seventy-four consecutive patients with unilateral axillary lymph node dissection undergoing latissimus dorsi flap underwent doppler and color duplex sonography of the thoracodorsal pedicle preoperatively. Non operated and contralateral pedicle served as reference. A total of 12.2% patients had differences between operated and non operated pedicle, 9.5% had smaller operated pedicle and 2.7% patients had stenosis with altered blood flow. Stenosis of the pedicle contraindicates, in our unit, latissimus dorsi flap because of altered blood flow. There were no flap necrosis in our series. The percentage of stenosed pedicle in our series is similar to percentage of flap necrosis in the literature. We think that systematic doppler and color duplex sonography of the thoracodorsal pedicle increase the reliability of latissimus dorsi flap by excluding pedicle with altered blood flow.
authors.affiliation: Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France. julien.pauchot@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Pauchot
authors.forename: S
authors.initials: S
authors.lastname: Aubry
authors.forename: E
authors.initials: E
authors.lastname: Rodiere
authors.forename: B
authors.initials: B
authors.lastname: Kastler
authors.forename: Y
authors.initials: Y
authors.lastname: Tropet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D006085:Graft Survival; D006801:Humans; D008197:Lymph Node Excision; D016462:Mammaplasty / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D018615:Ultrasonography, Doppler, Color