Prophylactic nipple-sparing mastectomy with immediate breast reconstruction: results of a French prospective trial.

Background: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is used increasingly when performing a prophylactic mastectomy. Few prospective studies have reported on complication rates. This complementary trial to the French prospective multicentre MAPAM trial aimed to evaluate the nipple-areola complex (NAC) necrosis rate in prophylactic NSM with IBR.

Predictive value of the milking patency test when performing the arterial microanastomosis in head and neck surgery.

Background: The milking patency test (MPT) is widely used to assess the patency of microanastomosis, despite it being proven to be a traumatic test.

Methods: We performed microanastomoses with intentional two-wall stitches and asked senior microsurgeons to evaluate the permeability of the anastomoses by looking first at the results of the MPT, then according to artery pulsation.

Results: Microsurgeons were all accurate in evaluating normal or clamped anastomoses.

Tolerance of latissimus dorsi in immediate breast reconstruction without implant to radiotherapy.

Introduction: Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported by patients who underwent IBR by LDF with or without subsequent radiotherapy.

[Patient with homozygous sickle cell disease and free flap surgery: Ensuring the success of the procedure].

Sickle cell anaemia is rare in France but frequent in Africa, leading to rigid, sickle-like shape red blood cells which bind together blocking microcirculation under certain circumstances. The vaso-occlusive crisis is the most frequent clinical manifestation especially in case of homozygous disease. Sickle cells disease is therefore usually considerated as a contraindication to microsurgery, however sometimes, a free flap procedure is mandatory.

[Axillary lymph node dissection after breast reconstruction by pedicled Latissimus dorsi: Operative steps and outcomes].

Objectives: We retrospectively reviewed all the cases of axillary lymph node dissection (ALND) performed within a year after an immediate breast reconstruction procedure by a pedicled Latissimus dorsi, which is transferred to the anterior thoracic wall through an axillary funnel. Operative technical steps are described taking account of the new anatomical relationship of the axilla.

Methods: We assessed postoperative immediate complications and late sequelaes.