Satake Toshihiko, Nakasone Reiko, Kobayashi Shinji, Maegawa Jiro
Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.
Department of Plastic and Reconstructive Surgery, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
Indian J Plast Surg. 2016 Jan-Apr;49(1):91-4. doi: 10.4103/0970-0358.182248.
The lumbar artery perforator (LAP) flap, which contains excess skin and fat tissue, love handles, that extends from the lower back to upper buttock, may provide an alternate tissue source for autologous breast reconstruction. However, LAP flap use during this procedure frequently requires vessel interposition grafts to correct the short flap pedicle length and mismatched recipient vessel calibre. A 46-year-old patient underwent a right nipple-sparing mastectomy using a lateral approach for ductal carcinoma in situ and immediate LAP flap breast reconstruction. The lateral thoracic vessel served as the recipient vessel, and a lateral thoracic vein interposition graft from the distal remnant was performed to adjust the arterial length and size discrepancy between the recipient lateral thoracic artery and pedicle artery. This procedure facilitates microsurgical anastomosis and medialisation of LAP flap to make a natural decollete line and create a cleavage for the reconstructed breast.
腰动脉穿支（LAP）皮瓣包含从下背部延伸至上臀部的多余皮肤和脂肪组织（即“游泳圈”），可为自体乳房重建提供另一种组织来源。然而，在此手术过程中使用LAP皮瓣时，常常需要进行血管间置移植，以纠正皮瓣蒂部长度过短和受区血管口径不匹配的问题。一名46岁患者因原位导管癌接受了右侧保乳乳房切除术，采用外侧入路，并立即进行了LAP皮瓣乳房重建。胸外侧血管作为受区血管，进行了远端残端的胸外侧静脉间置移植，以调整受区胸外侧动脉与蒂部动脉之间的动脉长度和尺寸差异。此手术有助于LAP皮瓣的显微外科吻合和向内侧移位，以形成自然的乳沟线，并为重建乳房创造乳沟。
