Immediate Breast Reconstruction Using an Expanded Latissimus Dorsal Musculocutaneous Flap Without Body Position Change
Bibliographic record
Abstract
Background: Breast reconstruction using expanded latissimus dorsal musculocutaneous flap (eLDMC flap) is known for excellent outcome; however, intraoperative change in body position to assess cosmesis prolongs operative time. Here, we present the results and the strengths of immediate breast reconstruction with an eLDMC flap without body position change that we have developed. Methods: Two hundred twenty-three patients who underwent total mastectomy followed by immediate breast reconstruction using eLDMC flaps between November 2010 and December 2018 at Wakayama Medical University Hospital were analyzed for operative times, complications, conformity, local recurrence, and distant metastasis. Forty-eight patients without reconstruction during the same period were also analyzed. Results: The median time of follow-up after operation was 57 months (0 - 121 months). The mean operation time was 183.6 min (115 - 291 min), which was approximately 4 - 6 h shorter than the reported technique with body position changes. Complications occurred in 130 patients (58.3%) and there was seroma in 103 patients (79.2%). There was local recurrence in 12 cases (5.4%), and distant metastasis occurred in six cases (2.7%). The recurrence rate was equivalent to that of previous reports. A total of 208 patients (93.3%) were evaluated to be excellent or good. Conclusion: Immediate breast reconstruction with an eLDMC flap without body position change is a safe, quick, and sufficient surgical procedure. Our surgical method achieves shorter operation times without compromising cosmetic appearance or increasing the complications and recurrence rate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".