Volumetric Feasibility of Lumbar Artery Perforator Flaps Compared to Abdominal Flaps for Breast Reconstruction in Low-BMI Patients: A CT-Based Study.
Abstract
[BACKGROUND] Although abdominal flaps remain the gold standard for autologous breast reconstruction, their use in low-BMI patients-particularly in bilateral cases or when matching a contralateral large breast-can be limited by concerns about insufficient volume. The lumbar artery perforator (LAP) flap has emerged as a potential alternative. This study evaluated its volumetric adequacy in lean patients using computed tomographic angiography (CTA)-based analysis.
[METHODS] Between 2019 and 2024, patients with BMI ≤ 25 who underwent abdominal flap-based breast reconstruction were retrospectively reviewed. Flap volumes were assessed using CTA. LAP flap volumes were compared with (1) 50% of estimated abdominal flap volume to simulate bilateral reconstruction and (2) estimated abdominal flap volumes based on inset rates from bipedicled cases. Comparisons were stratified by BMI: < 23 and 23-25.
[RESULTS] A total of 177 patients were included. The estimated abdominal and LAP flap volumes were 695.0 and 486.6 cm, respectively, both positively correlated with BMI. The LAP-to-abdominal flap volume ratio increased as BMI decreased. LAP flap volume exceeded 1.0 relative to 50% of abdominal volume in over 90% of cases, especially in the BMI < 23 group. In bipedicled DIEP flap cases, the average abdominal inset ratio was 0.84; accordingly, the adjusted LAP-to-abdominal flap volume ratio was 0.87 overall and 0.92 in the BMI < 23 group.
[CONCLUSIONS] The LAP flap volume was found to be comparable to that of the abdominal flap in a meaningful proportion of lean patients. These findings suggest it may serve as a reasonable alternative in cases requiring bilateral or bipedicled abdominal flap reconstruction.
[LEVEL OF EVIDENCE III] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
[METHODS] Between 2019 and 2024, patients with BMI ≤ 25 who underwent abdominal flap-based breast reconstruction were retrospectively reviewed. Flap volumes were assessed using CTA. LAP flap volumes were compared with (1) 50% of estimated abdominal flap volume to simulate bilateral reconstruction and (2) estimated abdominal flap volumes based on inset rates from bipedicled cases. Comparisons were stratified by BMI: < 23 and 23-25.
[RESULTS] A total of 177 patients were included. The estimated abdominal and LAP flap volumes were 695.0 and 486.6 cm, respectively, both positively correlated with BMI. The LAP-to-abdominal flap volume ratio increased as BMI decreased. LAP flap volume exceeded 1.0 relative to 50% of abdominal volume in over 90% of cases, especially in the BMI < 23 group. In bipedicled DIEP flap cases, the average abdominal inset ratio was 0.84; accordingly, the adjusted LAP-to-abdominal flap volume ratio was 0.87 overall and 0.92 in the BMI < 23 group.
[CONCLUSIONS] The LAP flap volume was found to be comparable to that of the abdominal flap in a meaningful proportion of lean patients. These findings suggest it may serve as a reasonable alternative in cases requiring bilateral or bipedicled abdominal flap reconstruction.
[LEVEL OF EVIDENCE III] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | flap
|
피판재건술 | dict | 13 | |
| 해부 | breast
|
유방 | dict | 4 | |
| 시술 | diep flap
|
피판재건술 | dict | 1 |
📑 인용 관계
이 논문이 참조한 문헌 26
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