Thomas Jordan, Waxweiler Charlotte, Leveque Raphaël, Cuylits Nicolas
Plastic, Reconstructive, and Aesthetic Surgery Department, Erasmus Hospital, Brussels, Belgium.
Radiology Department, Erasmus Hospital, Brussels, Belgium.
Plast Reconstr Surg Glob Open. 2020 Feb 10;8(2):e2628. doi: 10.1097/GOX.0000000000002628. eCollection 2020 Feb.
The lumbar artery perforator (LAP) flap takes an important place in lumbosacral reconstruction and in breast reconstruction. Although studies on the location of lumbar perforators in women are common, no anatomical study has focused solely on male subjects. Our objective is to facilitate the surgical approach to the LAP flap in male subjects by precisely ascertaining the characteristics of the perforators.
We performed a retrospective review of computed tomographic angiography images of a cohort of 30 patients evaluating the perforator position from the 4 lumbar arteries. In addition, 4 characteristics were studied: the length, the diameter, the path of the lumbar pedicle, and the thickness of tissues available for transfer.
One hundred five lumbar perforating vessels were analyzed on 60 posterior hemi-bodies, of which 86% came from the third and fourth lumbar arteries. The average location was situated 7.4 cm from the midline and in a 6-cm vertical wide area. The position of the lumbar perforator was independent of body mass index, abdominal circumference, and subject size. Our results, compared to previous studies, show no difference in this position between men and women.
The LAP flap is useful for regional reconstructions and as a free flap for both women and men. We provide male-specific tracking values for the dissection of lumbar perforating vessels. Dominant perforators were found to be situated in a wide region of 4 cm × 6 cm in the lumbosacral region at 7.4 cm from the midline.
腰动脉穿支（LAP）皮瓣在腰骶部重建和乳房重建中占据重要地位。虽然关于女性腰穿支位置的研究较为常见，但尚无解剖学研究仅聚焦于男性受试者。我们的目的是通过精确确定穿支的特征，为男性受试者的LAP皮瓣手术入路提供便利。
我们对30例患者的计算机断层血管造影图像进行了回顾性分析，评估了4条腰动脉的穿支位置。此外，还研究了4个特征：长度、直径、腰蒂路径以及可供转移的组织厚度。
在60个后半体上分析了105条腰穿支血管，其中86%来自第三和第四腰动脉。平均位置距离中线7.4厘米，位于一个6厘米垂直宽的区域内。腰穿支的位置与体重指数、腹围和受试者体型无关。与先前的研究相比，我们的结果显示男女在这个位置上没有差异。
LAP皮瓣对男女的区域重建和游离皮瓣移植均有用。我们提供了用于腰穿支血管解剖的男性特异性追踪值。发现主要穿支位于腰骶部距中线7.4厘米处一个4厘米×6厘米的广泛区域内。
