ArticleBreast cancer (Tokyo, Japan)2023
The transverse myocutaneous gracilis flap (TMG) for breast reconstruction: ipsi vs. contralateral harvest-aesthetic outcome and refinement procedures.
Article in Breast cancer (Tokyo, Japan), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- Evaluating the efficacy and safety of various flaps in Autologous Breast Reconstruction: a Bayesian network meta-analysis.Frontiers in medicine · 2024Pooled it
- Impact of Adjuvant Radiotherapy on Free Flap Volume in Autologous Breast Reconstruction: A Scoping Review.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe TMG flap is a popular choice for breast reconstruction. However, it remains unclear whether the side of flap harvest, subsequent flap shaping and inset impacts breast appearance and volume dispersion. This study compares the aesthetic outcome of the reconstructed breast following TMG flap harvest from the ipsilateral or contralateral thigh. PATIENT AND
methodsA retrospective matched-pair multi-center study was conducted. Patients were grouped according to the side of flap harvest (ipsilateral vs. contralateral) and matched for age, BMI and mastectomy type. Between 01/2013 and 03/2020, 384 TMG breast reconstructions were performed, of which 86 were included (43 ipsilateral vs. 43 contralateral). Standardized pre- and postoperative photographs were evaluated using a modified assessment scale comprising of a symmetry score (SymS, max. 20 points), a volume discrepancy score (VDS, max. 8 points) and an aesthetic appearance score (AS, max. 10 points). Autologous fat grafting (AFG) procedures for breast refinement were compared.
resultsPleasing breast symmetry (SymS Ipsi: 14.5/20; Contra: 14.9/20), volume (VDS Ipsi: 3.3/8; Contra: 2.4/8) and aesthetic appearance (AS Ipsi: 6.7/10; Contra: 6.7/10) were achieved with both surgical methods. No significant changes were present regarding the VDS (F(1.82) = 2.848, p = 0.095) or the SymS (F(1.82) = 1.031, p = 0.313) pre- to postoperatively. Significantly more autologous fat grafting was done in the contralateral group (p < 0.001).
conclusionThe side of the TMG flap harvest, different shaping and inset techniques do not impact the aesthetic breast outcome. Both surgical methods result in pleasing breast symmetry and volume. Secondary procedures are common and should be entailed in the reconstructive strategy.
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