title: Permanent latissimus dorsi muscle denervation in breast reconstruction.
abstract: BACKGROUND
  A retrospective analysis of our series of denervated latissimus dorsi (LD) breast reconstructions showed a high incidence of postoperative LD contraction. Anatomical studies with a prospective clinical trial are set up to outline a successful denervation procedure.
  
  
  METHODS
  Fifteen fresh cadavers were dissected to study thoracodorsal nerve course. Subsequently, 40 consecutive LD breast reconstructions were divided randomly in equal groups and underwent either distal (group A) or proximal (group B) nerve resection and clipping. The presence of postoperative contraction was evaluated clinically and instrumentally at 2-year follow-up. Statistical analysis of data was performed by Fisher exact test.
  
  
  RESULTS
  Cadaver dissections showed distal branching of thoracodorsal nerve in 20% of cases. Incidence of postoperative LD contraction was 35% (7/20) in group A and 0% in group B. A significantly lower rate of contraction in group B was demonstrated (P = 0.004).
  
  
  CONCLUSIONS
  Type B proximal nerve resection allows for effective denervation reducing incidence of postoperative contraction (P = 0.004).
authors: From the Plastic Surgery Chair, Faculty of Medicine and Psychology, University of Rome "Sapienza," Rome, Italy.
authors: Guido
authors: G
authors: Paolini
authors: Benedetto
authors: B
authors: Longo
authors: Rosaria
authors: R
authors: Laporta
authors: Michail
authors: M
authors: Sorotos
authors: Matteo
authors: M
authors: Amoroso
authors: Fabio
authors: F
authors: Santanelli
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009119:Muscle Contraction; D009121:Muscle Denervation / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D064171:Superficial Back Muscles / Q000294:innervation / Q000601:surgery*; D013524:Surgical Flaps / Q000294:innervation*; D016896:Treatment Outcome