부산대학교 도서관

Background This study aimed to determine the magnitude of volume reduction of the latissimusdorsi (LD) muscle after treatment using only postoperative radiotherapy (PORTx) in patientswho underwent immediate breast reconstruction using an extended LD musculocutaneous(eLDMC) flap after partial mastectomy. Methods We retrospectively reviewed 28 patients who underwent partial mastectomy andan eLDMC flap, received only PORTx, and underwent chest computed tomography (CT) 7 to10 days after surgery and 18±4 months after the end of radiotherapy, from March 2011 toJune 2016. The motor nerve to the LD was resected in all patients. One plastic surgeon performedthe procedures, and the follow-up period was at least 36 months (mean, 46.6months). The author obtained LD measurements from axial CT views, and the measurementswere verified by an experienced radiologist. The threshold for statistical significance was setat P<0.05. Results A statistically significant decrease in the LD volume was found after the end ofPORTx (range, 61.19%–80.82%; mean, 69.04%) in comparison to the measurements obtained7 to 10 days postoperatively (P<0.05). All cases were observed clinically for over 3 years. Conclusions The size of an eLDMC flap should be determined considering an average LD reductionof 69% after PORTx. Particular care should be taken in determining the size of an eLDMCflap if the LD is thick or if it occupies a large portion of the flap.