Escolha do vaso receptor em reconstrução de mama microcirúrgica
2013
BACKGROUND: Microvascular transfer of autogenous tissue have become the gold standard for breast reconstruction. As in any free tissue reconstruction, recipient vessel choice is fundamental for adequate planning in breast reconstruction. The purpose of the present study is to determine which of the available recipient vessels (the internal mammary artery and its perforators vessels or circumflex scapular vessels) are adequate for microvascular breast reconstruction. METHODS: A retrospective analysis of 117 consecutive patients who underwent microvascular breast reconstruction between January 2005 and December 2007 was performed. An algorithm that could be applied to the selection of the recipient vessel based in the axillary node dissection, immediate or late reconstruction, preoperative radiotherapy was established. Flap related complications, conversion rate and clinical outcomes were analised. RESULTS: The internal mammary perforator, the internal mammary and the circumflex scapular are adequate recipient vessels for breast reconstruction, with similar rates of complications and viability. We also observed a lower flap viability rate when using superficial inferior epigastric artery flap comparing to deep inferior epigastric artery perfurator and transverse rectus abdominis musculocutaneous with muscle preservation flaps. CONCLUSIONS: Microsurgical breast reconstruction is a safe and reliable method, with high flap viability and low complications.
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