Department of Surgery, Nakagami Hospital, Okinawa, Okinawa, Japan.
Surg Endosc. 2010 Jan;24(1):103-7. doi: 10.1007/s00464-009-0533-0. Epub 2009 Jun 4.
Recent advances in endoscopic surgery have allowed laparoscopic harvesting of the omental flap with minimal deformity of the donor site. This study aimed to assess the safety and long-term complication rate for laparoscopic harvest of the omental flap (LHOF).
From April 2002 to December 2008, 96 patients underwent LHOF for immediate reconstruction after breast cancer surgery. All the patients were evaluated for operating time, length of hospital stay, and the short- and long-term complications associated with LHOF.
The omental flap was harvested successfully in 95 of 96 cases, and the total success rate for harvesting of the omental flaps was 99% without conversion to open surgery. The median operative time for harvesting of the omental flap was approximately 1 h. Five cases of partial graft necrosis (5.2%) and two cases of vascular injury (2.1%) to the gastroepiploic artery and vein occurred, and the graft survival rate was 96.8% (93 of 95 cases). Laparoscopy-associated complications occurred in eight cases (8.3%), including one incisional hernia.
As a safe and minimally invasive procedure, LHOF has a low incidence of short- and long-term complications. This technique can expand the indications and usefulness of the omental flap.
内镜手术的最新进展使得腹腔镜下获取网膜瓣成为可能,且供区损伤极小。本研究旨在评估腹腔镜下获取网膜瓣(LHOF)的安全性和长期并发症发生率。
2002 年 4 月至 2008 年 12 月,96 例乳腺癌术后患者接受 LHOF 即时重建。所有患者均评估手术时间、住院时间,以及与 LHOF 相关的短期和长期并发症。
96 例患者中有 95 例成功获取了网膜瓣,网膜瓣总成功率为 99%,无中转开放手术。获取网膜瓣的中位手术时间约为 1 小时。5 例发生部分移植组织坏死(5.2%),2 例胃网膜血管损伤(2.1%),移植组织存活率为 96.8%(93/95 例)。腹腔镜相关并发症 8 例(8.3%),包括切口疝 1 例。
作为一种安全、微创的操作,LHOF 的短期和长期并发症发生率较低。该技术可以扩大网膜瓣的适应证和用途。