The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients.

T. Duymaz, Z. E. İyigün, A. S. İlgün, Ç. Ordu, M. Üçüncü, G. Alço, Alper Öztürk, Filiz Elbüken, F. Aktepe, V. Özmen
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Abstract

Objective The aim of this study is to investigate the effect of mini latissimus dorsi flap (MLDF) reconstruction on ipsilateral shoulder functions. Materials and Methods Those included in the study are the patients aged between 23 and 73, who were operated with the diagnosis of early breast cancer (cT1-3)N0). The first group includes the patients who had sentinel lymph node biopsy (SLNB) with partial mastectomy. The second group consists of the patients who had axillary lymph nodule dissection (ALND) with partial mastectomy. The third group includes the patients who had SLNB and MLDF with partial mastectomy. The fourth group includes the patients who had ALND and MLDF with partial mastectomy. Patients' Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score work model point were recorded. Results 174 patients were included in this study. According to Q-DASH score, no functional change was detected in 69.5% of the patients, whereas slight functional loss was identified in 23.6%, moderate functional loss in 5.7%, severe functional loss 1.1%. In the comparison of Q-DASH scores in surgery groups, while these four groups were being analyzed, a significant difference was determined (p=0.007). When dual analyses were made, it was also established that the difference resulted from the group to which ALND and MLDF were applied together. Conclusion We conclude that MLDF application for reconstruction purposes after breast surgery has a negative impact on shoulder functions of the patients who had both of partial mastectomy and ALND.
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小背阔肌瓣重建对乳腺癌患者肩关节功能的影响。
目的探讨微型背阔肌皮瓣(MLDF)重建对同侧肩功能的影响。材料与方法纳入研究的患者年龄在23岁至73岁之间,诊断为早期乳腺癌(cT1-3)N0)。第一组包括进行前哨淋巴结活检(SLNB)并进行乳房切除术的患者。第二组为乳房切除术后腋窝淋巴结清扫(ALND)的患者。第三组包括进行部分乳房切除术的SLNB和MLDF患者。第四组包括接受部分乳房切除术的ALND和MLDF患者。记录患者手臂、肩膀和手部快速残疾(Q-DASH)评分工作模型点。结果174例患者纳入本研究。根据Q-DASH评分,69.5%的患者未检测到功能变化,而轻度功能丧失为23.6%,中度功能丧失为5.7%,重度功能丧失为1.1%。在对这四组患者进行分析的同时,对手术组的Q-DASH得分进行比较,确定了显着差异(p=0.007)。当进行双重分析时,还确定了这种差异是由ALND和MLDF一起应用的组引起的。结论乳腺手术后应用MLDF重建对同时进行乳房切除术和ALND的患者的肩部功能有负面影响。
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