title: A retrospective study of lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator flaps for breast cancer treatment-induced upper-limb lymphoedema.
abstract: Breast cancer-related lymphoedema (BCRL) is a common and intractable complication. To evaluate the possible complications of using lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator (TRAM/DIEP) flaps for breast reconstruction and BCRL treatment, 20 patients with moderate or severe BCRL were retrospectively enrolled between November 2012 and October 2014. 10 patients had undergone lymphatic TRAM/DIEP flap surgery were assigned to the surgery group. 10 patients unwilling to undergo reconstruction were assigned to the physiotherapy group treated with traditional physical therapy. Upper-limb movement and circumference were measured and patients' subjective assessment was assessed using a questionnaire. In the surgery group, all flaps were successfully transferred. BCRL in 8 patients was improved by one level. The upper-limb circumference returned to normal in 1 case, and only 1 patient did not improve. In the physiotherapy group, a slight improvement was noted in 6 patients and unchanged in four cases. From the questionnaires, patients underwent lymphatic TRAM/DIEP flap surgery reported a significantly greater improvement in the affected limb (p < 0.05). In the physiotherapy group, the limb subjective did not improve as well as in the surgery group. Lymphatic TRAM/DIEP is a safe and effective option for patients who suffer from post-mastectomy lymphoedema.
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Zhuangqing
authors.initials: Z
authors.lastname: Yang
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Huang
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Jiankui
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Head and Neck Surgery, the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xi
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Yang
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Jianyun
authors.initials: J
authors.lastname: Nie
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Tianning
authors.initials: T
authors.lastname: Zou
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Shaoqing
authors.initials: S
authors.lastname: Zhou
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China.
authors.forename: Xueliang
authors.initials: X
authors.lastname: Tang
authors.affiliation: The 2nd Department of Breast Surgery, Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University, Yunnan province, China. chendedian2006@126.com.
authors.forename: Dedian
authors.initials: D
authors.lastname: Chen
mesh_terms: D000072656:Breast Cancer Lymphedema / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D019074:Epigastric Arteries / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation; D006801:Humans; D016462:Mammaplasty; D064827:Myocutaneous Flap / Q000637:transplantation; D061525:Perforator Flap / Q000637:transplantation; D026741:Physical Therapy Modalities; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity / Q000473:pathology*