The practice of breast reconstruction with abdominal tissue in a Hong Kong high caseload centre

Abstract

Aim: In the recent few years, the breast centre of Hong Kong West Cluster, that is Queen Mary Hospital and Tung Wah Hospital, has had the highest caseload of breast reconstruction among all hospitals in the Hospital Authority. Immediate breast reconstruction with abdominal tissue is the most common surgery performed for our breast cancer patients. In this article, the goal and timing of reconstruction, various reconstructive options, our experience in breast reconstruction using abdominal tissue and the extra microvascular procedures are described.

Patients and Methods: From January 2016 to December 2018, 155 female patients underwent breast reconstruction. The mean age was 46.5 (range 32–68 years). All required total mastectomy as the treatment of breast cancer.

Results: A total of 163 breast reconstructions were performed in our unit. 153 (93.9%) were reconstructions with autologous tissue, 10 (6.1%) were pure implant reconstructions. Of the 153 autologous tissue reconstructions, 123 (80.4%) were abdominal tissue reconstructions and 30 (19.6%) were latissimus dorsi myocutaneous flap reconstructions.

Conclusions: Abdomen is the most popular donor site of autologous tissue for breast reconstruction. Pedicled transverse rectus abdominis myocutaneous (TRAM) flap and free deep inferior epigastric perforator flap are the reliable flap options. Venous superdrainage is an extra procedure that was performed routinely in TRAM breast reconstruction to reduce the incidence of venous congestion.