Laparoscopic treatment of Poland's syndrome using the omentum flap technique

• Autor(a) principal: Costa, Sirlei Santos
• Data de Publicação: 2010
• Outros Autores: Blotta, Rosa Maria, Mariano, Mirandolino Batista, Meurer, Luise, Edelweiss, Maria Isabel Albano
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Clinics
• DOI: 10.1590/S1807-59322010000400009
• Texto Completo: https://www.revistas.usp.br/clinics/article/view/18442
• topic: Poland's syndrome; Omentum flap; Breast deformities; Laparoscopically harvested omentum flap; Breast asymmetry

OBJECTIVE: For patients with Poland's syndrome, a transverse skin fold in the anterior axillary pillar, infra-clavicular depression and an anomalous breast contour are the most uncomfortable disfigurements. This study aims to demonstrate that superior aesthetic results can be achieved by using a laparoscopically harvested omentum flap to treat this condition. METHODS: From a prospectively maintained clinical database of patients undergoing a laparoscopic omentum flap procedure for breast reconstruction, all of the patients with Poland's syndrome were identified and their outcomes were studied. RESULTS: Thirteen consecutive patients with Poland's syndrome were treated and evaluated regarding breast contour, reconstruction of the anterior axillary pillar and filling of the infra-clavicular depression. Implants were employed beneath the flap in 76% of cases to improve symmetry. In 23% of cases, a contra-lateral mastopexy was performed, and in 15% of cases, a breast implant was used. The consistency of the flap is similar to natural breast tissue and only a small incision in the breast fold is needed. The majority of patients (85%) were female, with a mean age of 26 (18-53). The flap is extremely malleable, adapts to irregular surfaces, and has a long vascular pedicle. Additionally, its removal does not leave a scar at the donor site as the removal of muscular flaps does. For example, the removal of the latissimus dorsi flap causes a deformity in the dorsal contour. The mean operative time was 201 minutes (80-350) and the mean hospital stay was 2.3 days (1-5). CONCLUSIONS: The outcomes of these patients revealed that the omentum flap technique provided superior amelioration of the deformities caused by Poland's syndrome when compared with other reconstructive options.