Delayed breast reconstruction with the thoracodorsal flap and endoprosthesis after complex treatment of breast cancer

Breast reconstruction with a thoracodorsal flap (TDF) in combination with a tissue expander/implant is a wellestablished technique. The purpose of the study was to present current data on the results of delayed breast reconstruction with thoracodorsal flap and tissue expander after combined/complex treatment in patients with breast cancer. Material and methods . The search for relevant sources was carried out in the PubMed, Cochrane Library, E-library systems, publications from 2014 to 2022 were studied. Delayed breast reconstruction using TDF in combination with a tissue expander/implant is a reliable method of reconstruction for the group of patients who have previously undergone radical mastectomy or adjuvant external beam radiation therapy in terms of combined/complex treatment of breast cancer, allowing to achieve good and excellent aesthetic results with a low incidence of surgical complications. Results and discussion. The use of the latissimus dorsi flap is a reliable and universal method of breast reconstruction, it allows achieving good and excellent aesthetic results, high patient satisfaction. Patients with a low body mass index or obesity, a history of abdominal surgery, including abdominoplasty, are not candidates for reconstruction using anterior abdominal wall flaps, and therefore the only possible method of breast reconstruction for them is the method using the TDF. In addition, the use of the TDF may be most appropriate for women who are planning a pregnancy in the future and for whom the use of anterior abdominal wall flaps will not be an optimal method of reconstruction due to reduced abdominal wall compliance. Other reasons why the use of TDF is the method of choice for many surgeons are the possibility of closing the donor site regardless of the size of the skin flap taken, the possibility of closing such defects of the mammary gland as extrusions, protrusions, in case of insufficiency of the skin cover after skin-preserving mastectomies. Conclusion. The use of the latissimus dorsi flap is a reliable and universal method of breast reconstruction, it allows achieving good and excellent aesthetic results, a high degree of patient satisfaction.