Department of Surgery, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Clinics (Sao Paulo). 2011;66(2):307-12. doi: 10.1590/s1807-59322011000200021.
The purpose of this study was to describe the probable mechanism of the volume increase of laparoscopically harvested omentum flaps used to treat breast deformities.
A histological analysis of omentum samples was performed to study the volume increase of laparoscopically harvested omentum flaps. Samples were harvested immediately after the transposition of the omentum from the abdominal cavity to the breast region and during the second surgical procedure for breast symmetrization of eight patients submitted to the transposition of the omentum flap. Changes in the morphometric measurements of the adipocytes (perimeter, diameter, and area), microvascular density (as measured by the CD31 endothelial marker), and immunohistochemical expression of VEGF were documented.
The increases in adipocyte size and microvascular density were statistically significant (P < 0.012). The expression levels of VEGF were lower in the second set of samples when compared to the first set, but the differences were not statistically significant (P < 0.093).
These results demonstrate an increase in cellular volume as measured by adipocyte perimeter, diameter, and area. Moreover, the increase in the number of vessels in the second set of samples suggests that neoangiogenesis was stimulated by the initial increase in VEGF expression levels observed in the first set of samples. The increase in VEGF expression in the flap may have been caused by adipocyte hypertrophy resulting from neoangiogenesis.
本研究旨在描述腹腔镜采集的网膜瓣体积增加的可能机制，用于治疗乳房畸形。
对网膜样本进行组织学分析，以研究腹腔镜采集的网膜瓣体积增加的原因。在 8 例接受网膜瓣转位的患者中，网膜从腹腔转移到乳房区域后，立即进行网膜转位，并在第二次乳房对称手术中采集样本。记录脂肪细胞（周长、直径和面积）、微血管密度（以 CD31 内皮标志物测量）和 VEGF 的免疫组织化学表达的形态测量学测量的变化。
脂肪细胞大小和微血管密度的增加具有统计学意义（P<0.012）。与第一组相比，第二组样本中 VEGF 的表达水平较低，但差异无统计学意义（P<0.093）。
这些结果表明，脂肪细胞周长、直径和面积的细胞体积增加。此外，第二组样本中血管数量的增加表明，初始 VEGF 表达水平的增加刺激了新血管生成。瓣内 VEGF 表达的增加可能是由新血管生成引起的脂肪细胞肥大引起的。
