Evaluation of the Intercostal Artery Perforator (ICAP) Flaps versus Lateral Thoracic Artery Perforator (LTAP) Flap in Partial Breast Reconstruction Following Breast Conservative Surgery.

Awin, Albino A.; A. Aziza, Sameh R.; Elnahas, Waleed; Wahab, Khaled M. A.

doi:10.21608/EJSUR.2024.279332.1033

	Evaluation of the Intercostal Artery Perforator (ICAP) Flaps versus Lateral Thoracic Artery Perforator (LTAP) Flap in Partial Breast Reconstruction Following Breast Conservative Surgery.
The Egyptian Journal of Surgery
Volume 43, Issue 4, October 2024, Page 1178-1190 PDF (1.94 MB)
Document Type: Original Article
DOI: 10.21608/EJSUR.2024.279332.1033
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Authors
Albino A. Awin^* ¹; Sameh R. A. Aziza²; Waleed Elnahas²; Khaled M. A. Wahab²
¹Department of Surgery, Upper Nile University, Malakal, South Sudan
²Department of Surgical Oncology, Oncology Center, Mansoura University, Dakahlia, Egypt
Abstract
Introduction: The introduction of pedicled chest wall perforator flaps (CWPF) in breast surgery, increased the options for oncoplastic volume replacement procedures, however, the literature is scarce on nonblind nonrandomized interventional studies comparing intercostal artery perforator (ICAP) flaps versus lateral thoracic artery perforator (LTAP) flaps in Partial breast reconstruction. This research was designed to assess the ICAP flaps versus the LTAP flaps in partial breast reconstruction in small and medium-sized breast women, in terms of aesthetic outcomes, patient satisfaction, and perioperative complications. Patients and Methods: This study was a nonblind nonrandomized interventional study, conducted on 34 female cases with early breast cancer, who underwent conservative breast surgery and partial reconstruction, either by the ICAP flaps or the LTAP flap. Results: In this study, 34 cases were allocated to 20 patients in the ICAP flaps group, and 14 cases in the LTAP flaps group. The mean total follow-up period was 33.10±11.96 versus 12.15±10.92, P less than 0.001*. The average age was 40.60±8.62 versus 43.07±8.01, and the average BMI was 32.19±6.80 versus 33.74±4.60 for the ICAPs versus LTAP groups, respectively. The most common complications encountered were marked seroma, experienced by 5 cases in the two groups without statistically significant difference. Overall, the aesthetic outcomes were good to excellent in over 90% of the cases in the two groups without statistically significant difference, P=0.608. Most of the cases were very satisfied with the aesthetic outcomes (n=19, 95.0%) versus (n=12, 85.7%) for the ICAP versus the LTAP flaps, respectively without statistically significant differences, P=0.455. Conclusion: The ICAP and the LTAP flaps are both versatile, risk-free surgical techniques, associated with low complications rate, very good to excellent aesthetic outcomes, and a high patient satisfaction rate.
Keywords
Chest wall perforator flaps; intercostal artery perforator flaps; lateral thoracic artery perforator


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