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Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer
Introduction Scarring and volume reduction of the axillary space resulting in persistent lymphedema is a side effect of axillary treatment in breast cancer patients. The aim of this paper is to describe the reduction of lymphedema achieved with a turnover flap. Materials and Methods Between October...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234824/ https://www.ncbi.nlm.nih.gov/pubmed/32435069 http://dx.doi.org/10.1055/a-1063-6310 |
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author | Marx, Mario Geßner, Michael Florek, Alexander Morgenstern, Susanne Passin, Stefan Brucker, Sara Y. Wallwiener, Diethelm Hahn, Markus |
author_facet | Marx, Mario Geßner, Michael Florek, Alexander Morgenstern, Susanne Passin, Stefan Brucker, Sara Y. Wallwiener, Diethelm Hahn, Markus |
author_sort | Marx, Mario |
collection | PubMed |
description | Introduction Scarring and volume reduction of the axillary space resulting in persistent lymphedema is a side effect of axillary treatment in breast cancer patients. The aim of this paper is to describe the reduction of lymphedema achieved with a turnover flap. Materials and Methods Between October 2016 and May 2018, five patients with grade 2 lymphedema following breast cancer therapy underwent reconstructive surgery with a turnover flap. Complete excision of the symptomatic axillary scar tissue followed by re-augmentation using a turnover flap was performed. Subsequently, all patients underwent breast reconstruction using a distant flap reconnected to the thoracodorsal vessels. The circumference of both arms, quality of life and pain were measured before and after surgery. Results An average reduction in pain in the ipsilateral arm from 6 to 1 on the numerical scale as well as an improvement in quality of life (2.8 vs. 7.0) was observed. A decrease in lymphedema especially in the upper arm was identified. No complications such as secondary bleeding, infections or flap loss were observed. Conclusion Complete removal of the axillary scar tissue after breast cancer treatment and re-augmentation of the axilla with a turnover flap results in a reduction in ipsilateral lymphedema and an improvement in pain and quality of life. We interpret these findings as a result of the physiological re-alignment of the lymphatic vessels combined with a lymph node-containing local transposition flap. Therefore, re-augmentation with a turnover flap could be an effective non-microsurgical alternative to lymph node transplantation. |
format | Online Article Text |
id | pubmed-7234824 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-72348242020-05-20 Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer Marx, Mario Geßner, Michael Florek, Alexander Morgenstern, Susanne Passin, Stefan Brucker, Sara Y. Wallwiener, Diethelm Hahn, Markus Geburtshilfe Frauenheilkd Introduction Scarring and volume reduction of the axillary space resulting in persistent lymphedema is a side effect of axillary treatment in breast cancer patients. The aim of this paper is to describe the reduction of lymphedema achieved with a turnover flap. Materials and Methods Between October 2016 and May 2018, five patients with grade 2 lymphedema following breast cancer therapy underwent reconstructive surgery with a turnover flap. Complete excision of the symptomatic axillary scar tissue followed by re-augmentation using a turnover flap was performed. Subsequently, all patients underwent breast reconstruction using a distant flap reconnected to the thoracodorsal vessels. The circumference of both arms, quality of life and pain were measured before and after surgery. Results An average reduction in pain in the ipsilateral arm from 6 to 1 on the numerical scale as well as an improvement in quality of life (2.8 vs. 7.0) was observed. A decrease in lymphedema especially in the upper arm was identified. No complications such as secondary bleeding, infections or flap loss were observed. Conclusion Complete removal of the axillary scar tissue after breast cancer treatment and re-augmentation of the axilla with a turnover flap results in a reduction in ipsilateral lymphedema and an improvement in pain and quality of life. We interpret these findings as a result of the physiological re-alignment of the lymphatic vessels combined with a lymph node-containing local transposition flap. Therefore, re-augmentation with a turnover flap could be an effective non-microsurgical alternative to lymph node transplantation. Georg Thieme Verlag KG 2020-05 2020-05-18 /pmc/articles/PMC7234824/ /pubmed/32435069 http://dx.doi.org/10.1055/a-1063-6310 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Marx, Mario Geßner, Michael Florek, Alexander Morgenstern, Susanne Passin, Stefan Brucker, Sara Y. Wallwiener, Diethelm Hahn, Markus Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title | Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title_full | Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title_fullStr | Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title_full_unstemmed | Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title_short | Re-augmentation of the Axilla Using a Turn-Over Flap – a New Approach for the Surgical Treatment of Secondary Lymphedema After Breast Cancer |
title_sort | re-augmentation of the axilla using a turn-over flap – a new approach for the surgical treatment of secondary lymphedema after breast cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234824/ https://www.ncbi.nlm.nih.gov/pubmed/32435069 http://dx.doi.org/10.1055/a-1063-6310 |
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