Neurotized Dual-pedicle Deep Inferior Epigastric Perforator Flap With Vascularized Lymph Node Transfer for Unilateral...

Area of Science:

• Microsurgery
• Plastic Surgery
• Oncology

Background:

• Breast cancer treatment can lead to lymphedema and sensory loss.
• Unilateral breast reconstruction requires addressing both aesthetic and functional deficits.

Purpose of the Study:

• To evaluate the clinical outcomes of a combined surgical approach for unilateral breast reconstruction.
• To assess the efficacy of this technique in managing breast cancer-related lymphedema.
• To determine the impact on sensory restoration in the reconstructed breast.

Main Methods:

• Retrospective review of patients undergoing a dual-pedicle DIEP flap with direct neurotization and vascularized lymph node transfer (VLNT).
• Clinical evaluation of lymphedema status and breast sensation post-operatively.
• Data collected on operative time, length of stay, and complications.

Main Results:

• Five patients underwent the composite procedure with no flap loss or major complications.
• Four patients achieved complete resolution of lymphedema; one showed significant improvement.
• All patients reported protective sensation in the reconstructed breast within six months.
• Secondary symmetry procedures included fat grafting and implant augmentation.

Conclusions:

• The combination of dual-pedicle DIEP flap, neurotization, and VLNT is a feasible technique for breast reconstruction.
• This composite procedure effectively addresses lymphedema and restores sensation.
• The technique demonstrates reliable outcomes with acceptable morbidity.