To explore the clinical effect of the pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance for repairing breast defects after surgery in breast cancer patients.

From June 2021 to February 2024，9 patients with breast defects after surgery who met the inclusion criteria were admitted to the Department of Burns and Cutaneous Surgery of the First Affiliated Hospital of Air Force Medical University. All patients were female，aged 13 to 51 years. The breast cancer had not recurred. Among them，4 cases had skin defects after breast implant placement，5 cases had breast defects after breast cancer resection. The area of breast skin soft tissue defect ranged from 7.0 cm × 4.0 cm to 11.0 cm × 7.5 cm. All patients underwent debridement and then received repair with a pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance，and the donor area wounds were sutured in one stage. Postoperative anti-inflammatory，anticoagulation，and prevention of vascular spasm treatments were performed，and bed rest was required. Postoperatively，the blood supply of the flap was closely observed. The drainage tube was removed on postoperative day 3, and the sutures were removed 12-14 days after the operation. Observed the wound healing，breast shape，and whether the tumor recurred during follow-up.

The flaps of all 9 patients survived well after the operation. The postoperative follow-up period was 6 to 12 months. During the follow-up period，no cases of breast cancer recurrence were observed. For the 4 patients with exposed implants，the wounds had completely healed，and no implants re-exposure occurred. Among the 5 patients with breast defects，the wounds healed well，but there were certain differences in shape between the reconstructed and the contralateral breast in 3 cases. The incisions in the donor area healed well，and only 1 case had obvious scar hyperplasia，which was significantly improved after laser treatment. The linear scars formed by the transverse incision in the donor area could be covered by clothing，and the impact on appearance was slight.

The pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance for repairing breast defects after surgery in breast cancer patients offers several advantages，including simple intraoperative operation，favorable aesthetic outcomes at the donor area，facilitation of implant retention，and prevention of implant re-exposure. It is a safe and effective surgical technique.