Abstract
The latissimus dorsi (LD) flap is a reliable option for breast reconstruction. This
is particularly true in patients with contraindications to abdominally based autologous
breast reconstruction. A systematic review of patient satisfaction and health related
quality of life following LD breast reconstruction using the BREAST-Q survey was conducted.
The scope of the review was to determine the degree of patient satisfaction following
the procedure and to examine how patient satisfaction from the pedicled LD flap compares
to other breast reconstructive procedures. A literature search on BREAST-Q in LD flap
reconstruction was performed. Only articles written in English and in published peer-reviewed
journals were included. Studies with less than 20 patients in their sample and those
with a follow-up period of less than 1 year were excluded. Five articles representing
331 patients were reviewed, including one case–control study and four retrospective
cohort studies. Level of evidence was either III (4) or IV (1). The average age was
53 with average body mass index of 25. Most reconstructions were delayed (67%) and
unilateral (88%), and most patients required radiation (79%). The average length of
follow-up was 36 months, and the response rate was 75%. Overall, patients who underwent
LD flap reconstruction reported favorable outcomes in satisfaction domains and quality
of life domains with few complications. A meta-analysis also demonstrated higher satisfaction
in LD flap without implants compared with LD flap with implants. Patient-reported
outcomes following LD breast reconstruction compare favorably with other techniques
of breast reconstruction.
Keywords breast reconstruction - latissimus dorsi flap - BREAST-Q - patient satisfaction
