title: Endoscopic axillary lymphadenectomy combined with laparoscopically harvested pedicled omentum for immediate breast reconstruction.
abstract: BACKGROUND
  To determine the therapeutic and cosmetic outcomes of patients with breast cancer treated with endoscopic axillary lymphadenectomy (EAL) combined with laparoscopically harvested pedicled omentum (LHPO) for immediate breast reconstruction.
  
  
  METHODS
  Forty patients with early breast cancer underwent EAL, followed by quadrantectomy and LHPO for immediate breast reconstruction. All patients were evaluated for operating time, blood loss, postoperative hospital stay, complications, etc. The cosmetic outcomes were evaluated 6 months after the surgery, according to the Harris criteria.
  
  
  RESULTS
  The average operating time was 308 min, including 39 min for EAL, 63 min for quadrantectomy, and 58 min for LHPO. The average blood loss was 70 ml, and was mainly incurred during breast resection. On average, the patients were discharged 9.5 days after the surgery. Partial graft necrosis and omental fat liquefaction occurred in one patient each. No other complications occurred after the surgery. No local recurrence or distant metastasis was found during the follow-up. The cosmetic results were mostly satisfactory. No size reduction of the reconstructed breast occurred after radiation therapy. Esthetic evaluation of the reconstructed breast showed that the cosmetic outcome was "excellent" in 35 patients, "good" in 4 patients, and "fair" in 1 patient.
  
  
  CONCLUSIONS
  EAL combined with LHPO for breast reconstruction is a viable, safe procedure that causes minimal surgical trauma and results in a soft, shapely breast postoperatively.
authors.affiliation: Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
authors.forename: Pusheng
authors.initials: P
authors.lastname: Zhang
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Luo
authors.forename: Jianwen
authors.initials: J
authors.lastname: Deng
authors.forename: Guoli
authors.initials: G
authors.lastname: Shao
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.forename: Zonghai
authors.initials: Z
authors.lastname: Huang
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D011183:Postoperative Complications; D013524:Surgical Flaps; D016896:Treatment Outcome