title: Laparoscopic treatment of Poland's syndrome using the omentum flap technique.
abstract: OBJECTIVE
  For patients with Poland's syndrome, a transverse skin fold in the anterior axillary pillar, infra-clavicular depression and an anomalous breast contour are the most uncomfortable disfigurements. This study aims to demonstrate that superior aesthetic results can be achieved by using a laparoscopically harvested omentum flap to treat this condition.
  
  
  METHODS
  From a prospectively maintained clinical database of patients undergoing a laparoscopic omentum flap procedure for breast reconstruction, all of the patients with Poland's syndrome were identified and their outcomes were studied.
  
  
  RESULTS
  Thirteen consecutive patients with Poland's syndrome were treated and evaluated regarding breast contour, reconstruction of the anterior axillary pillar and filling of the infra-clavicular depression. Implants were employed beneath the flap in 76% of cases to improve symmetry. In 23% of cases, a contra-lateral mastopexy was performed, and in 15% of cases, a breast implant was used. The consistency of the flap is similar to natural breast tissue and only a small incision in the breast fold is needed. The majority of patients (85%) were female, with a mean age of 26 (18-53). The flap is extremely malleable, adapts to irregular surfaces, and has a long vascular pedicle. Additionally, its removal does not leave a scar at the donor site as the removal of muscular flaps does. For example, the removal of the latissimus dorsi flap causes a deformity in the dorsal contour. The mean operative time was 201 minutes (80-350) and the mean hospital stay was 2.3 days (1-5).
  
  
  CONCLUSIONS
  The outcomes of these patients revealed that the omentum flap technique provided superior amelioration of the deformities caused by Poland's syndrome when compared with other reconstructive options.
authors.affiliation: Department of Surgery, Universidade Federal do Rio Grande do Sul, Rio Branco, PA, Brazil. sirlei@sirleicosta.com.br
authors.forename: Sirlei Santos
authors.initials: SS
authors.lastname: Costa
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Blotta
authors.forename: Mirandolino Batista
authors.initials: MB
authors.lastname: Mariano
authors.forename: Luise
authors.initials: L
authors.lastname: Meurer
authors.forename: Maria Isabel Albano
authors.initials: MI
authors.lastname: Edelweiss
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery; D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000033:anatomy & histology; D001940:Breast / Q000002:abnormalities*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D011045:Poland Syndrome / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
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