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Postablative Reconstruction Is Better Terminology than Oncoplastic Surgery

Al-Benna, Sammy, M.R.C.S., Ph.D.; Steinsträßer, Lars, M.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 463e-464e
doi: 10.1097/PRS.0b013e3181bf7fe3
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Klinik für Plastische Chirurgie und Schwerbrandverletzte, BG Kliniken Bergmannsheil, Ruhr-Universität, Bochum, Germany

Correspondence to Dr. Al-Benna, Klinik für Plastische Chirurgie und Schwerbrandverletzte, BG University Hospital Bergmannsheil, Ruhr-Universität, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany, sammyalbenna@doctors.org.uk

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Sir:

Art, indeed, consists in the conception of the result to be produced before its realisation in the material.

—Aristotle in De Partibus Animalium (On The Parts Of Animals), 350 BC

Ongoing innovations continue to advance effective surgical primary tumor control and are linked to improved surgical outcomes, minimized patient morbidity, and better quality of life. The term “oncoplastic” was first used in 1996.1,2 It originates from the Greek words onkos (ογκοσ), meaning bulk, mass, or tumor; and plastikos (πλαςτικóσ), meaning molded or shaped. These words together mean the molding of a tumor. This term is therefore unsatisfactory when applied to the combination of oncology surgery and plastic surgery.

Surgery is the oldest modality of cancer therapy and still forms the mainstay of treatment for solid tumors. Surgery operates by zero-order kinetics, in which all excised cells are killed. Ablation derives from the Latin ablatus, the irregular past participle of auferre, to carry away (ab-, away; plus latus, carried); it now has a specifically surgical edge, and today it applies principally to the surgical removal of any part of the body.3

During the past two decades, major improvements in both operative technique and the use of combined-modality therapy have significantly reduced the morbidity and mortality associated with the surgical treatment of solid neoplasms. For example, breast-preserving surgery has become an alternative to mastectomy in patients with breast carcinoma, and limb salvage is often possible in patients with bone and soft-tissue sarcomas. Advances in microvascular surgery now permit the free transfer of complex autologous tissues, such as free jejunal grafts to reconstitute the upper aerodigestive system or osteomyocutaneous flaps to reconstruct extremities and other mobile body parts such as the jaw.

Intuitively, it appears logical that the term “postablative reconstruction” is an appropriate term for the specialized art of surgery devoted to the restoration of form and function after the surgical removal of solid tumors.

Sammy Al-Benna, M.R.C.S., Ph.D.

Lars Steinsträßer, M.D.

Klinik für Plastische Chirurgie und Schwerbrandverletzte

BG Kliniken Bergmannsheil

Ruhr-Universität

Bochum, Germany

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REFERENCES

1.Hüter J. Tumor-adapted oncoplastic mastopexy and reduction-plasty (in German). Zentralbl Gynakol. 1996;118:549–552.
2.Gabka CJ, Bohmert H. Future prospects for reconstructive surgery in breast cancer. Semin Surg Oncol. 1996;12:67–75.
3.Compact Oxford English Dictionary (Web site). Available at: http://www.askoxford.com/concise_oed/ablation. Accessed June 22, 2008.

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