الفهرس 
Introduction
Implant based reconstructionOnly 14 pages are availabe for public view
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Abstract
Background: The goal of reconstruction is to restore a breast mound and to maintain the quality of life without affecting the prognosis or detection of recurrence of cancer. Autologous breast reconstruction has the advantage of creating natural breast and is associated with increased patient satisfaction. Aim of the work: Is to assess breast reconstruction using the DIEP flap in patient with breast cancer as regard Flap success, donor-site morbidity, mastectomy site complications, operative time and hospital stay. Patients and Methods: This is a prospective descriptive study where 20 patients with breast cancer from the Oncology Center Mansoura University underwent breast reconstruction by deep inferior epigastric artery perforator flap. Results: 4patients in this study had total flap loss,6 patients in this study underwent reoperation for redo anastomosis, the redo was for the venous anastomosis. The high percentage of flap loss could be attributed to the high BMI in this patient that increased the time of dissection and with difficult identification of perforators. Only one patient suffered from mild abdominal bulge post-operatively, this patient was obese with lax anterior abdominal wall. As regard donor site morbidity, two patient (10%) of patient developed either abdominal bulge or para umbilical hernia. Conclusions: Diep flap is novel technique with a lot of advantages but it needs increasing learning curve to reach the world wide results. Our experience in free tissue transfer is still growing but promising and necessitating building up experience in larger series of free tissue transfer to cope with international advance in breast reconstruction with free & perforator flaps. Micro vascular free flap technique in breast reconstruction is known to be safe, but enhanced attention to patient selection, preparation of patients for surgery, fluid balance, and coordination between experienced members of the team should increase effectiveness and safety even further. DIEP flap has many advantages over the other abdominally based flaps for breast reconstruction, as it decrease the incidence of donor site morbidity like bulge and hernia by eliminating sacrifice of rectus muscle and maintain the integrity of the overlying fascia, DIEP flaps effectively maintain abdominal wall stability even in obese patients.