Zuker R M, Filler R M, Lalla R
J Pediatr Surg. 1986 Dec;21(12):1198-200. doi: 10.1016/0022-3468(86)90039-4.
Intra-abdominal tissue expansion routinely occurs physiologically with pregnancy and may be seen in a variety of pathologic states. There are a number of situations where additional abdominal wall would be helpful. We encountered such a situation in a set of ischiopagus conjoined twins. In effect, separation would result in an abdominal wall deficit of approximately 50%. As an alternative to intraperitoneal air, we inserted two 1,000 mL tissue expanders through a subcostal incision at 6 months of age. Over the ensuing 7 weeks, each expander was gradually inflated to greater than capacity (1,250 mL each). Except for initial ileus, there was no difficulty in expanding the abdomen to enormous proportions. At the time of surgical separation, the expanders were removed and the available abdominal wall tissue almost closed directly on both children. Closure was complete in one baby, whereas a small upper abdominal wall defect was left in the other, necessitating Marlex reinforcement. There has been a recent explosion in the use of tissue expanders in reconstructive surgery. From head to toe, soft tissue can be expanded to be used as flaps, to close donor defects, or both. With this report, its use intra-abdominally is described. Future application is limited only by our ingenuity and imagination.
腹腔内组织扩张在生理上常随妊娠发生，也可见于多种病理状态。在许多情况下，额外的腹壁会有所帮助。我们在一对坐骨连体双胞胎中遇到了这样的情况。实际上，分离将导致约50%的腹壁缺损。作为腹腔内充气的替代方法，我们在患儿6个月大时通过肋下切口插入了两个1000毫升的组织扩张器。在随后的7周内，每个扩张器逐渐膨胀至超过其容量（每个1250毫升）。除了最初的肠梗阻外，将腹部扩张到极大的比例并无困难。在手术分离时，取出扩张器，现有的腹壁组织几乎直接在两个患儿身上闭合。一个婴儿的闭合是完全的，而另一个婴儿的上腹壁留下了一个小缺损，需要用Marlex补片加强。最近，组织扩张器在重建手术中的应用激增。从头到脚，软组织都可以被扩张以用作皮瓣，闭合供区缺损，或两者兼用。通过本报告，描述了其在腹腔内的应用。未来的应用仅受我们的创造力和想象力的限制。
