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CC BY 4.0 · Arch Plast Surg 2023; 50(04): 361-369
DOI: 10.1055/a-2045-8122
Breast/Trunk
Review Article

Systematic Review of Patient-Reported Outcomes and Complications of Pedicled Latissimus Flap Breast Reconstruction

Emanuela C. Peshel 
1   Division of General Surgery, Beaumont Health System, Royal Oak, Michigan
,
Claire M. McNary 
2   Department of Surgery, Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
,
Catherine Barkach 
2   Department of Surgery, Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
,
Elizabeth M. Boudiab 
1   Division of General Surgery, Beaumont Health System, Royal Oak, Michigan
,
Daniella Vega 
3   Division of Plastic and Reconstructive Surgery, Beaumont Health System, Royal Oak, Michigan
,
Farid Nossoni 
3   Division of Plastic and Reconstructive Surgery, Beaumont Health System, Royal Oak, Michigan
,
Kongkrit Chaiyasate 
2   Department of Surgery, Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
3   Division of Plastic and Reconstructive Surgery, Beaumont Health System, Royal Oak, Michigan
,
Jeremy M. Powers 
4   Division of Plastic and Reconstructive Surgery, Department of Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee
› Author Affiliations Funding The authors have no financial interest to declare in relation to the content of this article. No funding was received for this study.
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Abstract

The latissimus dorsi (LD) flap is a reliable option for breast reconstruction. This is particularly true in patients with contraindications to abdominally based autologous breast reconstruction. A systematic review of patient satisfaction and health related quality of life following LD breast reconstruction using the BREAST-Q survey was conducted. The scope of the review was to determine the degree of patient satisfaction following the procedure and to examine how patient satisfaction from the pedicled LD flap compares to other breast reconstructive procedures. A literature search on BREAST-Q in LD flap reconstruction was performed. Only articles written in English and in published peer-reviewed journals were included. Studies with less than 20 patients in their sample and those with a follow-up period of less than 1 year were excluded. Five articles representing 331 patients were reviewed, including one case–control study and four retrospective cohort studies. Level of evidence was either III (4) or IV (1). The average age was 53 with average body mass index of 25. Most reconstructions were delayed (67%) and unilateral (88%), and most patients required radiation (79%). The average length of follow-up was 36 months, and the response rate was 75%. Overall, patients who underwent LD flap reconstruction reported favorable outcomes in satisfaction domains and quality of life domains with few complications. A meta-analysis also demonstrated higher satisfaction in LD flap without implants compared with LD flap with implants. Patient-reported outcomes following LD breast reconstruction compare favorably with other techniques of breast reconstruction.

Keywords

breast reconstruction - latissimus dorsi flap - BREAST-Q - patient satisfaction

Authors' Contributions

Conceptualization: E.C.P., C.M.N., C.B., E.M.B, D.V., F.N., K.C., and J.M.P.

Methodology: E.C.P., C.M.N., C.B., E.M.B., D.V., FN., K.C., and J.M.P.

Data collection and analysis: E.C.P., C.M.N., C.B., E.M.B., K.C., and J.M.P.

Writing – original draft: E.C.P., C.M.N., C.B., E.M.B., K.C., and J.M.P.

Writing – review and editing: Peshel EC, E.C.P., C.M.N., C.B., and E.M.B.


Ethical Approval

The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, identification number CRD42021248616). This study did not require an ethics review as it summarized findings from existing publications rather than collect primary data.




Publication History

Received: 14 April 2022

Accepted: 15 February 2023

Accepted Manuscript online:
02 March 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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