Evaluation of Early Postoperative Outcomes of Latissimus Dorsi Myocutaneous Flap in Immediate Breast Reconstruction after Mastectomy for Breast Cancer

Abstract

Background: Breast reconstruction is an integral part of breast cancer surgery. While a plethora of options are available for breast reconstruction, the latissimus dorsi flap (LD) remains the flap of choice as a widely available, proven, and reliable modality for most surgeons. This study aimed to observe postoperative complications, cosmetic outcomes, and Quality of life (QoL) of immediate LDF breast reconstruction after mastectomy in Bangladeshi patients. Methods: This observational study was conducted at the NICRH, Bangladesh, who underwent immediate latissimus dorsi myocutaneous flap reconstruction after mastectomy for breast cancer. Data were collected on donor and breast site-related complications. Descriptive statistics, chi-square test, and ANOVA test were used for data analysis to explore the association among postoperative complications, comorbidities and QoL (quality of life). A p value < 0.05 was considered statistically significant. Results: A total number of 30 patients were included in the current study. Cosmetic outcomes demonstrated 85.71% of patients had ipsilateral shape in the Good to excellent range, 92.85% had cleavage and scar visibility, and 82.14% had breast symmetry in the good to excellent range were reported, using breast Q questionnaire for measuring QoL. High levels of patients satisfaction in treatment were found as 60.71% cases for probably, 10.71% cases for certainly, should have taken the same treatment and 32.14% cases reported very much resemble the other breast, 39.29% cases quite a bit resemble the other breast satisfaction with cosmetic result and about 64% cases higher score (16-20) of body image, despite 67.85% cases high levels of recurrence fear. Statistical analysis showed no significant association between postoperative complications and co-morbidities (p=0.74) or BMI (p=0.70), but revealed a significant correlation between postoperative complications and body image scores (p≤0.05). Conclusion: The study result suggested that LD flap breast reconstruction could be a feasible approach for Bangladeshi patients with acceptable complications and satisfactory cosmetic outcomes. It has a positive impact on all aspects of QoL with high patient satisfaction in respect to body image, high fear of recurrence, greater treatment satisfaction and cosmetic result.