BRANT (BREAST RECONSTRUCTION AND NODE TRANSPLANTATION) - A ONE-STAGE TRANSPLANTATION OF INGUINAL LYMPH NODES AND DELAYED BREAST RECONSTRUCTION. MODERN CONCEPT IN RECONSTRUCTIVE MICROSURGERY OF LYMPHATIC SYSTEM LESIONS

Abstract

Secondary lymphedema is one of the common complications after complex treatment of breast cancer. One of the promising methods of treatment of lymphatic edema at the moment is microsurgical autotransplantation of inguinal lymph nodes. Only one method for treating lymphatic edema with a one-stage breast reconstruction was the concept of TBAR (Total Breast Anatomy Restoration), which implies the use of an inguinal lymphatic flap in the unfree variant - with the inclusion of its DIEP flap for delayed breast reconstruction. Cons - the concept is limited to using only the DIEP flap. A patient suffering from lymphatic edema and in need of breast reconstruction may not have enough tissue on the anterior abdominal wall. Therefore, our goal was to create an alternative concept, not tied to a single flap. BRANT (Breast Reconstruction And Node Transplantation) means microsurgical autotransplantation of the inguinal lymph flap into the axillary region and the use of any of the available flaps, to restore anatomical structures and to replenish the volume of the breast. The proposed method allows achieving the following results: for the minimal amount of surgical interventions an attractive type of breast is restored and good results are achieved in the treatment of lymphatic edema of the hand.