[Expanders and the prosthetic short line in breast reconstruction after mastectomy: experience with the first 130 surgically treated cases]. / Gli espansori e la linea protesica "short" nella ricostruzione mammaria post mastectomia: esperienza sui primi 130 casi operati.

Breast reconstruction as now to be consider as a complementary treatment of breast cancer surgery. Between 1998-1999 we developed a project of collaboration with Polytech-Silimed Europe Gmbh for a new textured tissue expander. This new system allows expansion of the middle and lower quadrant of the breast acting a physiologic ptosis of the breast. Authors report their experience on the first 130 patients.

[Five hundred sixty-nine flaps used in reconstruction of the head and neck: morbidity analysis and results]. / Cinquecentosessantanove lembi utilizzati nelle ricostruzioni per tumori di testa e collo: analisi su morbilità e risultati.

Aim of the study is to provide high-level results in terms of functionality and softness of the tissues achieved with different reconstructive techniques performed in oncological surgery of the head and neck. Test group was composed of 528 patients recovered with a diagnosis of head and neck cancer. We performed 569 flaps: myocutaneous, cutaneous and fasciocutaneous, and free flaps. The clinical outcome and the morpho-functional evaluation show that free flaps can ensure excellent results, especially in defined anatomical areas such as the cervical-esophageal region, jaw and tongue. As to myocutaneous and cutaneous/fasciocutaneous flaps, they are still the first reconstructive choice, according to their minimal or no functional implications.

[Mechanical microanastomosis in reconstructive surgery of the neck and face]. / Le microanastomosi meccaniche in chirurgia ricostruttiva del distretto cervico-facciale.

Aim of the study is to report our preliminar experience with MCA Coupler System in mechanical microanastomoses performed in head and neck reconstructive surgery. During almost 7 months we performed 7 end-to-end venous anastomoses: 3 of them regarding the cephalic district. We had no vascular thrombosis, vascular congestion or flap loss. Mean time of execution of anastomosis with MCA Coupler System was 10 minutes. In our experence it is essential the choice of the appropriate size of the device and a good dissection of recipient vessels. In our opinion the Coupler System is an easy applicable device, and an efficient alternative to manual micro-anastomoses.

[500 reconstructive flaps in oncological surgery of the head and neck: critical review of 10 years experience]. / 500 lembi ricostruttivi nella chirurgia oncologica della testa e del collo. Revisione critica di 10 anni di esperienza.

AIM: Oncologic surgery of the head and neck, according to the principle of oncological radicality, involves large demolition often including skin, soft tissues and bone structures. The aim of this study is to provide a high-level perspective of results achieved in terms of functionality and softness with the different reconstructive techniques during the last ten years. METHODS: The test group was composed of 467 patients, hospitalised in the "Regina Elena" National Cancer Institute in Rome and treated for head and neck cancer; 86% of the treated patients suffered from stage III or IV of the disease. For the reconstructive phase, 506 flaps were used, 45.5% were myocutaneous flaps, 37.1% cutaneous and fasciocutaneous flaps and 17.4% free flaps. Ischemic complications occurred in 5.2% of the myocutaneous flaps group and in 10.3% of the free flaps group. RESULTS: "Minor complications" affected 3.9% of the cases in the free flaps group and 20.8% of cases in the myocutaneous flaps group. CONCLUSION: The analysis of the results shows that generally free flaps are more reliable than myocutaneous flaps in terms of minor complications, however they tend to prolong the patient's hospitalisation and increase the overall treatment cost. Furthermore in morpho-functional terms, free flaps ensure results, in defined anatomical areas (such as the cervical-esophageal region, jaw, tongue) that today cannot be compared to the "conventional" procedures. As for myocutaneous and cutaneous/ fasciocutaneous flaps, according to personal opinion they are still the first choice for reconstruction having minimal or no functional implications.