Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The Outcome of Radiation Therapy after Immediate Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction

유경횡복직근피판을 이용한 즉시 유방재건술 후 방사선 치료의 결과

  • Lee, Hyung-Chul (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Eun-Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Sei-Hyun (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Seung-Do (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Taik-Jong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 이형철 (울산대학교 의과대학 서울아산병원 성형외과학교실) ;
  • 김은기 (울산대학교 의과대학 서울아산병원 성형외과학교실) ;
  • 안세현 (울산대학교 의과대학 서울아산병원 외과학교실) ;
  • 안승도 (울산대학교 의과대학 서울아산병원 방사선종양학과학교실) ;
  • 이택종 (울산대학교 의과대학 서울아산병원 성형외과학교실)
  • Received : 2011.08.23
  • Accepted : 2011.09.29
  • Published : 2011.11.10
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Abstract

Purpose: The safety of radiation therapy after breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap is still being debated, and few studies exist on the outcome of irradiation after immediate TRAM breast reconstruction. Some authors presented satisfactory outcomes after adjuvant radiation therapy on reconstructed breast with pedicled TRAM flap, while others reported significant post radiation changes of the flap. Effect of radiation therapy on TRAM flap was evaluated to see whether adjuvant radiation therapy was tolerable. Methods: 1000 immediate TRAM breast reconstruction was done by a single surgeon from July, 2001 to December, 2009. Among them 105 patients required adjuvant radiation therapy because of advanced disease or locoregional recurrence. Fat necrosis, radiation fibrosis, mastectomy skin flap necrosis, need for secondary touch up procedures, patient satisfaction were evaluated. Results: The incidence of fat necrosis was 10.5% and significant radiation fibrosis occurred in only one patient. Delayed wound problem did not occur during or after irradiation. Secondary touch-up procedures were performed in 12.3%, the most common being fat graft (8.6%). Average patient satisfaction score was 8.62/10, which was not significantly different from the authors' previous report involving all the TRAM patients (8.50). Conclusion: Radiation therapy did not increase the complication rate significantly. Aesthetic result was affected but was tolerated in most cases. The fear of adjuvant radiation is not a negative factor in selecting immediate breast reconstruction with TRAM flap.

Keywords

References

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