title: Oncoplastic surgery with omental flap reconstruction: a study of 200 cases.
abstract: There are several small case series on use of a laparoscopically harvested omental flap (LHOF) for breast reconstruction. However, the long-term oncological safety and clinical benefits of the LHOF remain uncertain, especially in use of the flap in oncoplastic breast surgery.
  
  
  
  A retrospective chart review was performed for 200 patients who underwent oncoplastic breast surgery using a LHOF at our institution from April 2002 to March 2016. Laparoscopy-associated complications, local recurrence, and cosmetic outcomes were evaluated.
  
  
  
  Most of the patients underwent partial breast reconstruction immediately after breast-conserving surgery (BCS). The success rate of laparoscopic harvesting of the omental flap was 99.5%. The rate of complications was 12.0% and laparoscopy-associated complications occurred in four cases (2.0%). The rate of a positive margin was 6.5%. Two cases (1.0%) had local recurrence during a median follow-up period of 90 months. In 24 patients (12.0%), the volume of the flap was insufficient. When applied to total reconstruction, volume insufficiency occurred in 32.6% of patients. Cosmetic outcomes were mostly satisfactory. Approximately 80% of patients were rated as good or excellent by evaluation using a 4-point scale and Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software. Donor-site scars were negligible, as in laparoscopic cholecystectomy.
  
  
  
  The LHOF has minimal donor-site morbidity and deformity, and oncological safety is promising. There is a limit to the adaptable volume, but the LHOF is an attractive option in partial breast reconstruction after BCS.
authors.affiliation: Department of Breast Surgery, Nakagami Hospital, 610 Noborikawa, Okinawa-city, Okinawa, Japan. hisamitu@nakagami.or.jp.
authors.forename: Hisamitsu
authors.identifier: 0000-0001-8492-3715
authors.initials: H
authors.lastname: Zaha
authors.affiliation: Department of Breast Surgery, Nakagami Hospital, 610 Noborikawa, Okinawa-city, Okinawa, Japan.
authors.forename: Norie
authors.initials: N
authors.lastname: Abe
authors.affiliation: Department of Breast Surgery, Nakagami Hospital, 610 Noborikawa, Okinawa-city, Okinawa, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sagawa
authors.affiliation: Department of Breast Surgery, Nakagami Hospital, 610 Noborikawa, Okinawa-city, Okinawa, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Unesoko
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009852:Omentum / Q000601:surgery*; D012189:Retrospective Studies; D013518:Surgery, Plastic; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Breast reconstruction; Breast-conserving surgery; Laparoscopy; Omental flap; Oncoplastic surgery