Cargando…

Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI

Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience...

Descripción completa

Detalles Bibliográficos
Autores principales: Mahrhofer, Maximilian, Schoeller, Thomas, Casari, Maria, Bachleitner, Kathrin, Weitgasser, Laurenz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509377/
https://www.ncbi.nlm.nih.gov/pubmed/34640539
http://dx.doi.org/10.3390/jcm10194515
_version_ 1784582324849999872
author Mahrhofer, Maximilian
Schoeller, Thomas
Casari, Maria
Bachleitner, Kathrin
Weitgasser, Laurenz
author_facet Mahrhofer, Maximilian
Schoeller, Thomas
Casari, Maria
Bachleitner, Kathrin
Weitgasser, Laurenz
author_sort Mahrhofer, Maximilian
collection PubMed
description Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data.
format Online
Article
Text
id pubmed-8509377
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-85093772021-10-13 Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI Mahrhofer, Maximilian Schoeller, Thomas Casari, Maria Bachleitner, Kathrin Weitgasser, Laurenz J Clin Med Article Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data. MDPI 2021-09-29 /pmc/articles/PMC8509377/ /pubmed/34640539 http://dx.doi.org/10.3390/jcm10194515 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mahrhofer, Maximilian
Schoeller, Thomas
Casari, Maria
Bachleitner, Kathrin
Weitgasser, Laurenz
Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title_full Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title_fullStr Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title_full_unstemmed Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title_short Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI
title_sort development of a surgical treatment algorithm for breast reconstruction in poland syndrome patients considering severity, sex, and bmi
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509377/
https://www.ncbi.nlm.nih.gov/pubmed/34640539
http://dx.doi.org/10.3390/jcm10194515
work_keys_str_mv AT mahrhofermaximilian developmentofasurgicaltreatmentalgorithmforbreastreconstructioninpolandsyndromepatientsconsideringseveritysexandbmi
AT schoellerthomas developmentofasurgicaltreatmentalgorithmforbreastreconstructioninpolandsyndromepatientsconsideringseveritysexandbmi
AT casarimaria developmentofasurgicaltreatmentalgorithmforbreastreconstructioninpolandsyndromepatientsconsideringseveritysexandbmi
AT bachleitnerkathrin developmentofasurgicaltreatmentalgorithmforbreastreconstructioninpolandsyndromepatientsconsideringseveritysexandbmi
AT weitgasserlaurenz developmentofasurgicaltreatmentalgorithmforbreastreconstructioninpolandsyndromepatientsconsideringseveritysexandbmi