Division of Plastic and Reconstructive Surgery, Department of Surgery, Lenox Hill Hospital & Manhattan Eye, Ear, and Throat Hospital, New York, New York.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
J Reconstr Microsurg. 2020 Jul;36(6):438-444. doi: 10.1055/s-0040-1702176. Epub 2020 Feb 23.
Given the national trends in obesity, reconstructive surgeons are faced with an increasing number of overweight and obese women interested in postmastectomy breast reconstruction. While the link between obesity and adverse postoperative outcomes is well established, few studies have explored the relationship between body mass index (BMI) and the vasculature of the anterior abdominal wall.
A radiographic review was conducted on female patients who underwent computed tomographic angiography (CTA) of the anterior abdominal wall. CTA studies were evaluated for perforator caliber and quantity. Patients were stratified by BMI. The relationship between BMI and the diameter and number of deep inferior epigastric artery (DIEA) perforators was analyzed using analysis of variance using Minitab software with α of 0.05.
There were a total of 916 hemiabdomens included in this study. There was no statistically significant correlation between BMI and DIEA diameter or mean diameter of major (≥ 1 mm) DIEA perforators. There was a statistically significant negative correlation between BMI and the number of major DIEA perforators ( < 0.01).
Despite the increased demands of excess abdominal adiposity, DIEA perforator caliber was not correlated with BMI on CTA. The number of major DIEA perforators visualized on CTA decreased with increasing body weight may indicate a limitation of CTA for presurgical planning of abdominal free flaps in obese patients.
鉴于肥胖在全国范围内的趋势，重建外科医生面临着越来越多对乳房再造术后超重和肥胖女性的关注。虽然肥胖与不良术后结果之间的联系已经得到充分证实，但很少有研究探讨身体质量指数 (BMI) 与前腹壁血管之间的关系。
对接受前腹壁计算机断层扫描血管造影 (CTA) 的女性患者进行了放射学回顾。对 CTA 研究进行了评估，以评估穿支血管的口径和数量。根据 BMI 将患者分层。使用 Minitab 软件的方差分析分析 BMI 与深下腹动脉 (DIEA) 穿支血管直径和数量之间的关系，α 值为 0.05。
本研究共纳入 916 个半腹部。BMI 与 DIEA 直径或主要 (≥ 1mm) DIEA 穿支血管的平均直径之间无统计学显著相关性。BMI 与主要 DIEA 穿支血管数量之间存在统计学显著负相关（<0.01）。
尽管腹部多余脂肪的需求增加，但 CTA 上 DIEA 穿支血管的口径与 BMI 无关。CTA 上可观察到的主要 DIEA 穿支血管数量随着体重的增加而减少，这可能表明 CTA 对肥胖患者腹部游离皮瓣术前规划的局限性。
