A 50-year-old woman with morbid obesity and tumor recurrence in a mastectomy scar performed 4 years earlier.
He had received radiotherapy and chemotherapy at the time and the periodic reviews had been normal, until a subcutaneous lesion was detected in the scar itself, which grew at high speed.
She was referred to our department for evaluation of exeresis and reconstruction.
The extension study was negative.
Resection of the tumor was proposed with 4 cm. Under general and orotracheal intubation with bilumen, collapsed left and a second rib was performed from the parenchyma without pulmonary resection anterior axillary line margins.
Relocation of the wall, with direct loop suture between the first and third ribs and over it, coverage was performed with pedunculated rectus abdominis muscle flap, with horizontal skin island (TRAM).
The flap presented a venous return problem since it was rotated to the bed, so it was decided to perform a microanastomosis of the superficial inferior epigastric vein of the same to the left lateral thoracic vein immediately, the recipient returned.
The patient was discharged 5 days later without incidents and 2 years later remains free of disease and without ventilatory dysfunction.
