Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
Microsurgery. 2021 Feb;41(2):175-180. doi: 10.1002/micr.30679. Epub 2020 Nov 6.
Reconstruction of a full-thickness trunk defect is challenging because of the complex nature of such defects, which include the chest wall, abdominal wall, and diaphragm. We herein describe three patients in whom extensive trunk defects after sarcoma resection were reconstructed with a latissimus dorsi flap and an anterolateral thigh flap. In two patients, the defect included both the chest wall and the abdominal wall. The other patient had an extensive full-thickness chest wall defect. The size of the anterolateral thigh flap for each patient was 34 × 10 cm, 26 × 15 cm, and 23 × 5 cm, respectively. Although one patient required take-back for additional venous drainage, all wounds healed with no other complications. No respiratory dysfunction or abdominal wall hernia occurred in any patients. The combined use of a latissimus dorsi flap and an anterolateral thigh flap may provide reliable coverage of an extensive trunk defect and robust support of the chest and abdominal walls. Additionally, the availability of a two-team approach without a positional change makes this combination a versatile reconstructive option.
全层躯干缺损的重建具有挑战性,因为此类缺损的性质复杂,包括胸壁、腹壁和膈肌。我们在此描述了 3 例患者,他们在肉瘤切除后采用背阔肌皮瓣和股前外侧皮瓣重建了广泛的躯干缺损。在 2 例患者中,缺损包括胸壁和腹壁。另一名患者有广泛的全层胸壁缺损。每位患者的股前外侧皮瓣大小分别为 34×10cm、26×15cm 和 23×5cm。尽管有 1 例患者需要回取以增加静脉引流,但所有伤口均愈合,无其他并发症。患者均未发生呼吸功能障碍或腹壁疝。背阔肌皮瓣和股前外侧皮瓣的联合使用可为广泛的躯干缺损提供可靠的覆盖,并为胸壁和腹壁提供有力的支撑。此外,这种组合可采用无需变换体位的双团队方法,是一种多功能的重建选择。