
Lumbar flap in breast reconstruction: anatomical study on cadaveric material
Журнал: Пластическая хирургия и эстетическая медицина. 2026;(1):20-24.
DOI: 10.17116/plast.hirurgia202601120
Read: 1687 раз
Abstract
OBJECTIVE
To study topographic and anatomical features of lumbar perforator blood supply for breast reconstruction.
MATERIAL AND METHODS
The study included 20 unfixed human female cadavers (aged 63—75 years). We assessed vascular anatomy of the flap, length of the vascular pedicle and flap, width of the flap and exact location of L4 perforator on both sides.
RESULTS AND CONCLUSION
The LAP (lumbar artery perforator) flap appears to be a potentially useful option for autologous breast reconstruction, and the identified landmarks may facilitate preoperative planning. Further clinical studies are advisable to clarify parameters and evaluate clinical outcomes considering small length of vascular pedicle.
Keywords
- LAP flap
- breast reconstruction
- breast defects
Дата поступления: 30.11.2024
Дата принятия в печать: 15.08.2025
Дата публикации: 30.03.2026
- LoTempio MM, Allen RJ. Breast reconstruction with SGAP and IGAP flaps. Plast Reconstr Surg. 2010 Aug;126(2):393-401. PMID: 20679825. https://doi.org/10.1097/PRS.0b013e3181de236a
- Fansa H, Schirmer S, Warnecke IC, Cervelli A, Frerichs O. The transverse myocutaneous gracilis muscle flap: a fast and reliable method for breast reconstruction. Plast Reconstr Surg. 2008 Nov;122(5):1326-1333. PMID: 18971715. https://doi.org/10.1097/PRS.0b013e318188205f
- Tuinder SMH, Beugels J, Lataster A, de Haan MW, Piatkowski A, Saint-Cyr M, van der Hulst RRWJ, Allen RJ. The Lateral Thigh Perforator Flap for Autologous Breast Reconstruction: A Prospective Analysis of 138 Flaps. Plast Reconstr Surg. 2018 Feb;141(2):257-268. PMID: 29019861. https://doi.org/10.1097/PRS.0000000000004072
- Allen RJ Jr, Lee Z-H, Mayo JL, Levine J, Ahn C, Allen RJ Sr. The Profunda Artery Perforator Flap Experience for Breast Reconstruction. Plast Reconstr Surg. 2016 Nov;138(5):968-975. PMID: 27391834. https://doi.org/10.1097/PRS.0000000000002619
- Peters KT, Blondeel PN, Lobo F, van Landuyt K. Early experience with the free lumbar artery perforator flap for breast reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2015 Aug;68(8):1112-1119. Epub 2015 Apr 11. PMID: 26066849. https://doi.org/10.1016/j.bjps.2015.03.031
- Kiil BJ, Rozen WM, Pan WR, Grinsell D, Ashton MW, Corlett RJ, Taylor GI. The lumbar artery perforators: a cadaveric and clinical anatomical study. Plastic and Reconstructive Surgery. 2009 Apr;123(4):1229-1238. PMID: 19337091. https://doi.org/10.1097/PRS.0b013e31819f299e
- Vonu PM, Chopan M, Sayadi L, Chim HW, Leyngold M. Lumbar Artery Perforator Flaps: A Systematic Review of Free Tissue Transfers and Anatomical Characteristics. Ann Plast Surg. 2022 Oct 01;89(4):465-471. Epub 2022 Apr 23. PMID: 35502957. https://doi.org/10.1097/SAP.0000000000003216
- Satake T, Nakasone R, Kobayashi S, Maegawa J. Immediate breast reconstruction using the free lumbar artery perforator flap and lateral thoracic vein interposition graft for recipient lateral thoracic artery anastomosis. Indian J Plast Surg. 2016 Jan-Apr;49(1):91-94. PMID: 27274129; PMCID: PMC4878252. https://doi.org/10.4103/0970-0358.182248
- Startseva OI, Ermoshenkova MV, Frolova AS, Khanakhyan SG, Babushkina MI. Lumbar flap in breast reconstruction (literature review). Issues of Reconstructive and Plastic Surgery. 2024;27(1):51-60. (In Russ.). https://doi.org/10.52581/1814-1471/88/05
- Speck NE, Grufman V, Farhadi J. Trends and Innovations in Autologous Breast Reconstruction. Arch Plast Surg. 2023 May 29;50(3):240-247. PMID: 37256033; PMCID: PMC10226796. https://doi.org/10.1055/s-0043-1767788
- Haddock NT, Lakatta AC, Steppe C, Teotia SS. DIEP Flap versus PAP Flap versus LAP Flap: A Propensity-Matched Analysis of Aesthetic Outcomes, Complications, and Satisfaction. Plastic and Reconstructive Surgery. 2024 Oct 01; 154(4S):41S-51S. Epub 2024 Sep 20. PMID: 38507549. https://doi.org/10.1097/PRS.0000000000011405
- Myers PL, Nelson JA, Allen RJ Jr. Alternative flaps in autologous breast reconstruction. Gland Surg. 2021 Jan;10(1):444-459. PMID: 33634002; PMCID: PMC7882326. https://doi.org/10.21037/gs.2020.03.16
- Jeong W, Lee S, Kim J. Meta-analysis of flap perfusion and donor site complications for breast reconstruction using pedicled versus free TRAM and DIEP flaps. Breast. 2018 Apr;38:45-51. Epub 2017 Dec 08. PMID: 29227815. https://doi.org/10.1016/j.breast.2017.12.003
Recommended articles:
Breast reconstruction using synthetic film.Plastic Surgery and Aesthetic Medicine. 2026;(1):25-30
Clinical and anatomical rationale for the loop method in reconstructive and aesthetic breast surgery.Plastic Surgery and Aesthetic Medicine. 2026;(1):14-19
Comparative analysis of breast reconstruction outcomes using TRAM and DIEP flaps after mastectomy.Plastic Surgery and Aesthetic Medicine. 2025;(4):68-73
One-step DTI reconstruction using nanotextured implants in breast cancer patients. Direct results.P.A. Herzen Journal of Oncology. 2025;14(6):54-58
Surgical planning and choice of perforator vessel in delayed deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction.Plastic Surgery and Aesthetic Medicine. 2025;(3):5-11
Repeated breast reconstruction after previous complications.Pirogov Russian Journal of Surgery. 2025;(6):51-57
Fat grafting for breast shaping after implant removal.Plastic Surgery and Aesthetic Medicine. 2025;(2):61-69
Abdominal perforator exchange (APEX) technique in delayed breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flap.Plastic Surgery and Aesthetic Medicine. 2025;(2):52-60
Anatomical study and new design of lateral intercostal artery perforator (LICAP) flap.Plastic Surgery and Aesthetic Medicine. 2025;(1):24-31
Neoadjuvant drug therapy and oncological outcomes in patients with stage I–II breast cancer.P.A. Herzen Journal of Oncology. 2025;14(1):5-12
