The Experts below are selected from a list of 2628 Experts worldwide ranked by ideXlab platform

Warren M Rozen - One of the best experts on this subject based on the ideXlab platform.

  • 3d volumetric analysis for planning Breast Reconstructive Surgery
    Breast Cancer Research and Treatment, 2014
    Co-Authors: Michael P Chae, David J Huntersmith, Robert T Spychal, Warren M Rozen
    Abstract:

    Breast reconstruction plays an integral role in the holistic management of Breast cancer, with assessment of Breast volume, shape, and projection vital in planning Breast reconstruction Surgery. Current practice includes two-dimensional (2D) photography and visual estimation in selecting ideal volume and shape of Breast implants or soft-tissue flaps. Other objective quantitative means of calculating Breast volume have been reported, such as direct anthropomorphic measurements or three-dimensional (3D) photography, but none have proven reliably accurate. We describe a novel approach to volumetric analysis of the Breast, through the creation of a haptic, tactile model, or 3D print of scan data. This approach comprises use of a single computed tomography (CT) or magnetic resonance imaging (MRI) scan for volumetric analysis, which we use to compare to simpler estimation techniques, create software-generated 3D reconstructions, calculate, and visualize volume differences, and produce biomodels of the Breasts using a 3D printer for tactile appreciation of volume differential. Using the technique described, parenchymal volume was assessed and calculated using CT data. A case report was utilized in a pictorial account of the technique, in which a volume difference of 116 cm3 was calculated, aiding Reconstructive planning. Preoperative planning, including volumetric analysis can be used as a tool to aid esthetic outcomes and attempt to reduce operative times in post-mastectomy Breast reconstruction Surgery. The combination of accurate volume calculations and the production of 3D-printed haptic models for tactile feedback and operative guidance are evolving techniques in volumetric analysis and preoperative planning in Breast reconstruction.

  • predictors of blood transfusion in deep inferior epigastric artery perforator flap Breast reconstruction
    Journal of Reconstructive Microsurgery, 2011
    Co-Authors: Jeannette W C Ting, Warren M Rozen, Cara Michelle Le Roux, Mark W Ashton, Emilio Garciatutor
    Abstract:

    : Perioperative blood loss during and following Breast reconstruction Surgery can have substantial impact on free flap survival and patient morbidity. Transfusion rates of up to 95% have been reported following transverse rectus abdominis myocutaneous flap Breast reconstruction, with blood loss described as significant in most cases. However, there has been little reported of such requirements in patients undergoing deep inferior epigastric perforator (DIEP) flap Breast reconstruction. We present the transfusion requirements of 152 consecutive patients who underwent DIEP flap Breast reconstruction, with a view to quantifying transfusion requirements and identifying risk factors for such loss. In this cohort, 80.3% of patients required blood transfusion, with a mean volume of 3.9 U per patient. There was a statistically significant correlation for increased transfusion requirement in patients with preoperative anemia ( P < 0.001) and in bilateral cases ( P < 0.001), but not for cases of immediate reconstruction ( P = 0.72). Although blood loss in Breast Reconstructive Surgery is rarely large enough to be life-threatening, relative anemia does have significant effect on flap survival and patient morbidity. With risk factors for increased transfusion requirements identified in the current study, high-risk patients can be predicted preoperatively.

  • predictors of blood transfusion in deep inferior epigastric artery perforator flap Breast reconstruction
    Journal of Reconstructive Microsurgery, 2011
    Co-Authors: Jeannette W C Ting, Warren M Rozen, Cara Michelle Le Roux, Mark W Ashton, Emilio Garciatutor
    Abstract:

    Perioperative blood loss during and following Breast reconstruction Surgery can have substantial impact on free flap survival and patient morbidity. Transfusion rates of up to 95% have been reported following transverse rectus abdominis myocutaneous flap Breast reconstruction, with blood loss described as significant in most cases. However, there has been little reported of such requirements in patients undergoing deep inferior epigastric perforator (DIEP) flap Breast reconstruction. We present the transfusion requirements of 152 consecutive patients who underwent DIEP flap Breast reconstruction, with a view to quantifying transfusion requirements and identifying risk factors for such loss. In this cohort, 80.3% of patients required blood transfusion, with a mean volume of 3.9 U per patient. There was a statistically significant correlation for increased transfusion requirement in patients with preoperative anemia ( P < 0.001) and in bilateral cases ( P < 0.001), but not for cases of immediate reconstruction ( P = 0.72). Although blood loss in Breast Reconstructive Surgery is rarely large enough to be life-threatening, relative anemia does have significant effect on flap survival and patient morbidity. With risk factors for increased transfusion requirements identified in the current study, high-risk patients can be predicted preoperatively.

Andrew K Lee - One of the best experts on this subject based on the ideXlab platform.

  • silicone implant and primary Breast alk1 negative anaplastic large cell lymphoma fact or fiction
    International Journal of Clinical and Experimental Pathology, 2010
    Co-Authors: Andrew K Lee
    Abstract:

    The safety of silicone-based implant for mammoplasty has been debated for decades. A series of anecdotal case reports and a recent epidemiological case-control study have suggested a possible association between silicone implant and the development of primary Breast ALK1-negative anaplastic large cell lymphoma (ALCL), a rare type of peripheral T-cell lymphoma. In this report, we describe an additional case of primary Breast ALK1-negative ALCL in the fibrous capsule and cystic fluid of silicone Breast implant in a 58 year old woman who underwent Breast Reconstructive Surgery after lumpectomy for her infiltrating Breast adenocarcinoma. Morphologically and immunohistochemically, the lymphoma cells may be confused with recurrent infiltrating Breast adenocarcinoma or other non-hematolymphoid malignancies. Molecular studies were needed to determine T-lineage differentiation of the malignant lymphoma cells. We will also review the case reports and case series published in the English literature and discuss our current understanding of silicone implant in primary Breast ALK1-negative ALCL.

  • case report silicone implant and primary Breast alk1 negative anaplastic large cell lymphoma fact or fiction
    2010
    Co-Authors: Andrew K Lee
    Abstract:

    The safety of silicone-based implant for mammoplasty has been debated for decades. A series of anec- dotal case reports and a recent epidemiological case-control study have suggested a possible association between silicone implant and the development of primary Breast ALK1-negative anaplastic large cell lymphoma (ALCL), a rare type of peripheral T-cell lymphoma. In this report, we describe an additional case of primary Breast ALK1- negative ALCL in the fibrous capsule and cystic fluid of silicone Breast implant in a 58 year old woman who under - went Breast Reconstructive Surgery after lumpectomy for her infiltrating Breast adenocarcinoma. Morphologically and immunohistochemically, the lymphoma cells may be confused with recurrent infiltrating Breast adenocarcino - ma or other nonhematolymphoid malignancies. Molecular studies were needed to determine T-lineage differentia- tion of the malignant lymphoma cells. We will also review the case reports and case series published in the English literature and discuss our current understanding of silicone implant in primary Breast ALK1-negative ALCL.

Koenraad Van Landuyt - One of the best experts on this subject based on the ideXlab platform.

  • The Lumbar Artery Perforator Flap in Autologous Breast Reconstruction: Initial Experience with 100 Cases.
    Plastic and reconstructive surgery, 2018
    Co-Authors: Dries Opsomer, Filip Stillaert, Phillip Blondeel, Koenraad Van Landuyt
    Abstract:

    Background: The lumbar artery perforator flap is an alternative flap in Breast reconstruction for those patients who are not eligible for a deep inferior epigastric artery perforator (DIEAP) flap. Shaping of this flap is easier compared with other flaps because of the quality of the lumbar fat and the gluteal extension. Methods: Between October of 2010 and June of 2017, a total of 100 lumbar artery perforator free flap Breast reconstructions were performed in 72 patients. Patient demographics, indications, flap specifics, and complications were reviewed retrospectively. Results: Twenty-eight bilateral and 44 unilateral Breast reconstructions with a lumbar artery perforator flap were performed. Mean patient age was 48 years, and the average body mass index was 23.11 kg/m(2). The authors report 43 preventive mastectomies for elevated cancer risk with subsequent immediate reconstruction, 34 secondary reconstructions, and 14 tertiary reconstructions. Mean operative time was 7 hours 4 minutes, including the mastectomy in primary cases. Mean flap weight was 499 g (range, 77 to 1216 g) and mean follow-up time was 30 months. The revision rate was 22 percent and nine flaps were lost. Conclusions: The lumbar artery perforator flap is a valuable alternative to the DIEAP flap in Breast Reconstructive Surgery. It is an excellent flap for BRCA-positive patients who are typically young and have limited excess tissue at the conventional donor sites. Despite higher revision rates compared with the DIEAP flap, the lumbar flap is superior in mimicking the shape and feel of native Breast tissue. Scarring at the donor site remains a sore point but can be easily treated and used to an advantage to contour the flanks.

Hak Chang - One of the best experts on this subject based on the ideXlab platform.

  • the superficial inferior epigastric artery flap and its relevant vascular anatomy in korean women
    Archives of Plastic Surgery, 2014
    Co-Authors: Jun Ho Choi, Kyung Won Minn, Hak Chang
    Abstract:

    BACKGROUND: Lower abdominal soft tissue transfer is the standard procedure for Breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to Breast Reconstructive Surgery. METHODS: The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 Breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. RESULTS: SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (±12.87) mm, and -8.14 (±15.24) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (±0.39) mm and 1.37 (±0.33) mm, and they were found at a mean depth of 9.75 (±2.67) mm and 8.33 (±2.65) mm, respectively. CONCLUSIONS: The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful Breast reconstruction using SIEA flaps.

Ted Dubinsky - One of the best experts on this subject based on the ideXlab platform.