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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors evaluate the different procedures for breast reconstruction in order to determinate the best indication of each technique. From January 1983 to June 1992, 196 reconstructions for breast cancer using implants, including 100 immediate and 96 delayed, were performed. Different types of breast implants were used in this period: in 1983-84 46 double lumen prostheses were performed, in 1985-86 34 Radovan temporary tissue expanders, from January 1986 to June 1991 115 Becker and Gibney permanent tissue expanders and 8 microstructured prostheses. Due to unavailability of silicon-gel implants, from January to June 1992 12 breast reconstructions with saline temporary tissue expanders were performed. In the patients with radical mastectomy 39 latissimus dorsi muscular flaps were carried out for implant coverage. In the same decade 204 breast reconstructions using Rectus abdominis myocutaneous (TRAM) flaps, including 201 delayed and 3 immediate were performed. It can be concluded that the implants are first choice for small or medium size breast, with light ptosis, in immediate reconstruction and when the patients refuse harder surgical procedures. On the contrary the autologous tissue, such as TRAM flap, can be used in patients with redundant abdomen, with controlateral large and ptotic breast and in delayed reconstruction.
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PMID:[Considerations in immediate and delayed breast reconstruction]. 799 Nov 74

Inspired by successful reconstruction obtained using the Lewis-Ryan lower thoracic advancement flap to rebuild missing breast, we have adapted that extremely simple technique to prior serial expansions, in order to create more natural mounds, better defined submammary folds, and when possible, some grade of ptosis, without additional, new scarring. The procedure is introduced and compared to other such flaps as the TRAM and the latissimus dorsii. In our series, 30 patients were evaluated according to the quality of the final results, and the most frequent complication are pointed out and discussed.
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PMID:Breast reconstruction by expansion and advancement of the upper abdominal flap. 920 77

The authors consider 12 cases of breast-reconstruction after mastectomy, made with the Holmstrom's flap, to verify the validity and the real utility of this way of reconstruction. It has been made a follow-up of 4 years, to verify, in course of time, the characteristics of the reconstructed breasts. All the patients have been operated in a general surgery department. The Holmstrom's flap has been prevalently used in patients, during immediate reconstruction. The breast reconstruction, made with this fascio-cutaneous transposition flap, requires the use of prosthesis. The operating time has a very short duration. The breast reconstruction, made with this method, requires a very short staying in hospital. The nipple-areola complex reconstruction has been made in a second time, few months later. The patients have been examined periodically, to verify, immediately, the result of the flap and, later, the quality of the new breast's shape and the occurrence of capsular contracture. The results achieved with this reconstructive method are a good shape and ptosis as to confer great naturalness to the new breast. The authors conclude that, even if they use the TRAM-flap as first choice in breast-reconstruction, the Holmstrom's flap is a reconstructive technique of great utility in immediate breast reconstruction, that is able to give very good aesthetic results.
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PMID:[The use of Holmstrom's flap in breast reconstruction]. 947 84

Long time results of breast reconstruction after ablative surgery with skin expander and prothesis is perceived as unsatisfactory by most patients. Breast reconstruction with autologous tissue however is connected with a high technical expenditure and especially in the case of the free TRAM-flap connected with the risk of total loss of the transplanted tissue. In view of the total effort in secondary interventions, and reduction of the collateral side, the autologous reconstruction proves to need less time, resources and hospital admissions already after a 2 year period. Minor revisions mark the long time course of breast reconstruction with expander and prothesis. Judging by the patients themselves they prefer the reconstruction with autologous tissue and in this subgroup microsurgical reconstruction yields the better results to the patient. Review shows that the microsurgical procedure allows the transfer of larger volumes and better positioning of the breast including a physiologic breast ptosis. TRAM-flap donorsites seem to yield equal results in dynamic as well as static exercise regardless of the microsurgical or pedicled technique. The review of our own 48 patients with 50 TRAM-flaps coincide with the review of the current literature.
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PMID:[Breast reconstruction with the free microvascular abdominal flap. Accessory reconstruction or gold standard?]. 1006 88

Oncoplastic breast surgery is the fusion of oncological and surgical principles to gain successful breast tumour excision with good cosmesis. It is an widely accepted and popular method in the western world. However, the picture is different in India. The major issues here, like late detection and advanced tumours, poor socio-economic status overriding quality of life issue and shortage of dedicated oncoplastic surgeons result in a poor acceptance and practice of oncoplastic breast surgery. This article explores the use of various oncoplastic techniques in clinical practice and discusses future directions in this emerging field in an Indian perspective. In our institute (breast care unit, I.P.G.M.E&R,Kolkata), we performed a retrospective study over a period of five years (2005-2009). It included a sample size of 30 patients with diagnosed breast cancer or Phylloides Tumor (PT). The study focused on the indications, type of oncoplastic procedure used, cosmetic outcome (shape / volume replacement, ptosis correction & chest wall coverage), complications faced and response to subsequent therapy. The indications, for which oncoplastic techniques were applied, were DCIS (2), LCIS (1), IDC (19) and phylloides tumor (8). Of the 30 patients, RAT was used in 8, LDMF (of various types and volume) was used in 16, pedicled TRAM flap was used in 3 and reduction mastopexy in 3.The procedural indications of reconstruction were total glandular replacement by TRAM flap, mini-LDMF to fill volume loss after BCS or wide local excision, rotation advancement technique for reshaping / symmetry maintenance after BCS or wide local excision, LDMF for chest wall coverage after MRM and reduction mastopexy after wide local excision. From patient's point of view the outcome of surgery was highly satisfactory (score 3 or more) in 19 out of 30 patients (63.33%). LDMF was the most commonly used (16 out of 30) oncoplastic procedure with least complication rates (0 out of 16). 4 out of 30 patients had complications related to the procedure. Chest wall coverage after MRM still forms the main indication of oncoplastic surgery in this country.
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PMID:Oncoplastic Breast Surgery - Our Experiences in the Breast Clinic, IPGME&R, Kolkata. 2269 2