{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:57:03Z","timestamp":1790701023144,"version":"4.1.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The authors developed an innovative integrated approach combining reverse-sequence endoscopic nipple-sparing mastectomy with reverse-sequence endoscopic latissimus dorsi muscle flap (R-E-LDMF) harvest for breast reconstruction (BR) through a discreet axillary incision. Both techniques demonstrate clinical feasibility, but no systematic comparison of patient-reported outcomes, complications, and cost efficiency between endoscopic implant-based BR and R-E-LDMF BR exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective, 2-center cohort study was conducted from July of 2021 through March of 2024, enrolling patients with breast cancer who underwent reverse-sequence endoscopic nipple-sparing mastectomy followed by either dual-plane BR or R-E-LDMF BR. The primary end point was patient-reported outcomes assessed using the BREAST-Q reconstruction module (focusing on satisfaction with breasts and quality of life). Other end points included clinical outcomes, complications, and oncologic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 191 enrolled patients (41 R-E-LDMF versus 150 dual-plane), R-E-LDMF BR required longer operative times but incurred substantially lower hospitalization costs. After controlling for baseline patient characteristics, patients who underwent R-E-LDMF BR had greater satisfaction with their breasts (mean difference, \u22129.39 [95% CI, \u221216.97 to \u22121.80];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016) at 1 year compared with patients who underwent dual-plane BR. BREAST-Q scores showed no intergroup differences in quality of life. The R-E-LDMF group had higher rates of any and minor complications. Major complication rates and oncologic outcomes were similar between the 2 groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The R-E-LDMF BR technique achieved aesthetic results and major complication rates comparable to those of the dual-plane approach while significantly reducing overall medical costs, despite higher minor complication rates. This approach represents a cost-effective alternative for patients seeking optimal aesthetic results with reduced financial burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/prs.0000000000012923","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:08:15Z","timestamp":1770905295000},"page":"540-550","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Dual-Plane versus Endoscopic Latissimus Dorsi Muscle Flap Breast Reconstruction after Endoscopic Nipple-Sparing Mastectomy"],"prefix":"10.1097","volume":"158","author":[{"given":"Yu","family":"Feng","sequence":"first","affiliation":[{"name":"Department of General Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoman","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanzuo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donglin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Fourth People\u2019s Hospital of Sichuan Province, Chengdu, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Fourth People\u2019s Hospital of Sichuan Province, Chengdu, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faqing","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenggui","family":"Du","sequence":"additional","affiliation":[{"name":"Department of General Surgery"},{"name":"Breast Center, West China Hospital, Sichuan 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