Comparison of post-operative complications after immediate breast reconstruction by muscle-sparing latissimus dorsi flap versus total latissimus dorsi flap

Abstract

Introduction: Breast reconstruction using the latissimus dorsi (LD) muscle is a widely used technique. Muscle-sparing LD (MSLD) has yielded reductions in post-operative complications and improved quality of life. This study aimed to compare post-operative complications between conventional LD and MSLD, in patients undergoing immediate breast reconstruction (IBR).

Methods: We retrospective retrieved data on 77 patients who underwent IBR with either the LD or MSLD techniques between 1 January 2018 and 31 December 2021 in a single cancer centre in Dijon, France. Univariate and multivariate analysis was performed to compare post-operative complications between the LD and MSLD techniques, among patients undergoing IBR.

Results: Overall, 33 had MSLD and 44 had LD IBR. In multivariate analysis, length of hospital stay was significantly shorter in MSLD group (OR=0.99; IC 95%(0.16-0.7)]; P<0.001). The presence of donor site's seroma was significantly lower in MSLD group (OR=0.004; IC 95%(0.006-0.3); P=0.013). But the total number of lipofilling was significantly higher in MSLD group (OR=3.78; IC 95%(1.69-8.46); P<0.001) with no difference concerning the number of post-operative lipofilling. Concerning the duration of surgery, no difference was observed between the two groups.

Conclusion: The MSLD technique can be proposed in routine practice to patients with an indication for autologous IBR but the results of this study should be confirmed by a multicentre prospective study.

Keywords: Immediate breast reconstruction; Latissimus dorsi flap; Muscle-sparing latissimus dorsi flap; Seroma.