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巨大复发性甲状腺肿瘤切除术后应用双蒂腹壁下深动脉穿支游离皮瓣修复颈胸缺损:1例报告并文献复习

Reconstruction of cervico-thoracic defect with bipedicled deep inferior epigastric perforator free flap following resection of a giant recurrent thyroid tumor: a case report and review of literature.

作者信息

Zavala Abraham, Vargas María I, Ayala Walter, Muñoz Antonio, Chávez Miguel A, López Jesús, Delgado Ricardo

机构信息

Department of Plastic and Reconstructive Surgery, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru.

Department of Breast and Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru.

出版信息

J Surg Case Rep. 2023 Sep 5;2023(9):rjad491. doi: 10.1093/jscr/rjad491. eCollection 2023 Sep.

Abstract

The bipedicled Deep Inferior Epigastric Perforator (DIEP) flap, originally described and primarily utilized in autologous breast reconstruction for specific cases, has expanded its applications to encompass diverse anatomical regions in recent years. This report presents the case of a 69-year-old woman with a recurrent giant thyroid tumor who underwent surgical resection, resulting in a large cervico-thoracic defect effectively reconstructed using a bipedicled DIEP flap. The patient's postoperative recovery was uneventful, and the follow-up assessments revealed a healthy, well-perfused flap that provided sufficient coverage to critical structures, adequate restoration of the region contour, and enough volume to offset potential adverse effects of subsequent radiation therapy. In addition, this report incorporates a concise literature review highlighting the expanding indications of the bipedicled DIEP flap beyond breast reconstruction, showing the versatility and efficacy of the bipedicled DIEP flap in addressing complex soft-tissue defects in various anatomical areas.

摘要

双蒂腹壁下深动脉穿支(DIEP)皮瓣最初被描述并主要用于特定病例的自体乳房重建,近年来其应用范围已扩展到涵盖不同的解剖区域。本报告介绍了一名69岁患有复发性巨大甲状腺肿瘤的女性病例,该患者接受了手术切除,导致颈胸区域出现大的缺损,随后使用双蒂DIEP皮瓣有效地进行了重建。患者术后恢复顺利,随访评估显示皮瓣健康、血运良好,为关键结构提供了充分覆盖,使该区域轮廓得到充分恢复,并具有足够的体积以抵消后续放疗的潜在不良影响。此外,本报告还纳入了一篇简要的文献综述,强调了双蒂DIEP皮瓣在乳房重建之外不断扩大的适应证,显示了双蒂DIEP皮瓣在处理各种解剖区域复杂软组织缺损方面的多功能性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d45/10480101/3edaae0d96a6/rjad491f1.jpg

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