• Title/Summary/Keyword: latissimus dorsi

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Volumetric change of the latissimus dorsi muscle after postoperative radiotherapy in immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap

  • Park, Tae Seo;Seo, Jung Yeol;Razzokov, Anvar S.;Choi, June Seok;Kim, Min Wook;Lee, Jae Woo;Kim, Hyun Yeol;Jung, Youn Joo;Choo, Ki Seok;Song, Kyeong Ho;Nam, Su Bong
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.135-139
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    • 2020
  • Background This study aimed to determine the magnitude of volume reduction of the latissimus dorsi (LD) muscle after treatment using only postoperative radiotherapy (PORTx) in patients who underwent immediate breast reconstruction using an extended LD musculocutaneous (eLDMC) flap after partial mastectomy. Methods We retrospectively reviewed 28 patients who underwent partial mastectomy and an eLDMC flap, received only PORTx, and underwent chest computed tomography (CT) 7 to 10 days after surgery and 18±4 months after the end of radiotherapy, from March 2011 to June 2016. The motor nerve to the LD was resected in all patients. One plastic surgeon performed the procedures, and the follow-up period was at least 36 months (mean, 46.6 months). The author obtained LD measurements from axial CT views, and the measurements were verified by an experienced radiologist. The threshold for statistical significance was set at P<0.05. Results A statistically significant decrease in the LD volume was found after the end of PORTx (range, 61.19%-80.82%; mean, 69.04%) in comparison to the measurements obtained 7 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 reduction of 69% after PORTx. Particular care should be taken in determining the size of an eLDMC flap if the LD is thick or if it occupies a large portion of the flap.

Medial Retracted Large Rotator Cuff Tears (내측으로 퇴축된 대범위 회전근 개 파열)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Kim, Tae-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.212-219
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    • 2009
  • Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

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The Usefulness of the Two-Staged Pedicled Latissimus Dorsi (LD) Flap in Fourth-Degree Burns of Upper Extremity (상지의 4도 화상에서 두 단계의 유경 광배근 피판술의 유용성)

  • Kim, Jae Hyun;Seol, Seong Hoon;Chung, Chan Min;Park, Myong Chul;Cho, Sang Hun
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.68-73
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    • 2021
  • Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

Chest Wall Rreconstruction after Desmoid Tumor Resection -1 Case Report- (흉벽에 발생한 유건종 절제후 흉벽 재건술 -1례 보고-)

  • 김병균
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1075-1078
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    • 1995
  • The desmoid tumor has been reported as the most common histologic subtype of soft tissue sarcoma occuring in chest wall and it known to be highly recurrent. The treatment of choice is a radical wide resection including a safe margin of uninvolved structures around the grossly visible tumor. We report a case of chest wall reconstruction using Marlex sandwich and latissimus dorsi musculocutaneous flap after wide resection of desmoid tumor on the chest wall.

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Postpneumonectomy Esophagopleural Fistula: Muscle Flap Transposition for Closure (우측폐 전절제술후 발생한 식도늑막루의 수술 치험 : 1례 보고)

  • 이형교
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1275-1279
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    • 1990
  • Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.

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The Effects of Creatine Oral Delivery on the Muscular Activity and Blood Lactate Density of Rowing Athletes (크레아틴 구강투여가 조정선수들의 근활성도와 혈중젖산농도에 미치는 영향)

  • Heo, Bo-Seob;Ji, Jim-Gu
    • Journal of Fisheries and Marine Sciences Education
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    • v.27 no.2
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    • pp.537-545
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    • 2015
  • The purpose of this study is to investigate how effects creatine dosage has on the improvement of rowing athletes' performance ability. Rowing athletes were administered with creatine, through which to examine the change of athletic performance ability, blood fatigue substances, and muscular activity. The subjects (participants) of this Study consisted of 12 male rowing athletes at P University, with at least 5 years of rowing experiences, which divided into two groups - creatine dosing group of 6 persons and control group of 6 persons - for random sampling measurement. Enzymatic-colorimetric method using lacrate oxidase and 4-aminoantipyrine was performed for blood lactate level analysis, and wireless EMG system (QEMG-4: Lxtha Korea) for muscular activity analysis, with 4 channels set for data analysis. As body parts to be measured, two muscular parts - latissimus dorsi and lumbar spinel - were chosen. Then, on the 5th day from the date of administering them with creatine (that is, 4 days after dosing them with creatine), rowing movement with the highest level of activity was calculated as peak value, which was measured twice. The test data used for this Study were SPSS/PC 18.0, pre-movement and post-movement two-way ANOVA for repeated measurement for comparative analysis of each muscle, with significant level at .05. As a result, the change of blood lactate level was significantly higher in creatine dosing group than in non-dosing group (p<.05). As for the change of muscular activity, both latissimus dorsi and lumbar spinel showed a significantly higher change of muscle in creatine dosing group than in non-dosing group (p<.05 and p<.05, respectively).

Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report (소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례)

  • Rha, Eun Young;Oh, Deuk Young;Kim, Hye Young;Lee, Jung Ho;Moon, Suk Ho;Seo, Je Won;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.95-98
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    • 2010
  • Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.