Takada Aki, Mori Hiroki, Nishimura Yuki, Tanaka Kentaro, Okazaki Mutsumi
Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Japan.
Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Japan.
Asian J Surg. 2024 Aug 28. doi: 10.1016/j.asjsur.2024.08.043.
In deep inferior epigastric artery (DIEA) perforator (DIEP) flap breast reconstruction, the network with the superficial inferior epigastric artery (SIEA) is key to achieving stable subcutaneous blood flow to the flap. This study investigated how the diameter and location of the DIEA perforator affect continuity with the SIEA.
A retrospective analysis of 94 specimens from 47 patients who underwent DIEA perforator flap breast reconstruction was performed. Relationships between the diameter and location of the DIEA perforator and its continuity with the SIEA were examined on preoperative multi-slice computed tomography.
The largest DIEA perforator on each specimen showed continuity with the SIEA in 94 %, significantly more than the second (80 %; p = 0.027) or third largest perforator (76 %; p = 0.005). Medial perforators from 3 cm above to 3 cm below the umbilicus showed more continuity with the SIEA than lateral perforators (p = 0.008).
Selection of the largest perforator of DIEP flap is advantageous in terms of continuity with the SIEA. Also, near the umbilicus, medial perforators communicate with the SIEA more than lateral perforators.
在腹壁下深动脉（DIEA）穿支（DIEP）皮瓣乳房重建术中，腹壁下浅动脉（SIEA）网络是实现皮瓣稳定皮下血流的关键。本研究调查了DIEA穿支的直径和位置如何影响与SIEA的连续性。
对47例行DIEA穿支皮瓣乳房重建术患者的94个标本进行回顾性分析。在术前多层计算机断层扫描上检查DIEA穿支的直径和位置与其与SIEA的连续性之间的关系。
每个标本上最大的DIEA穿支与SIEA连续的比例为94%，显著高于第二大穿支（80%；p = 0.027）或第三大穿支（76%；p = 0.005）。脐上3 cm至脐下3 cm的内侧穿支与SIEA的连续性比外侧穿支更多（p = 0.008）。
就与SIEA的连续性而言，选择DIEP皮瓣的最大穿支是有利的。此外，在脐部附近，内侧穿支与SIEA的连通性比外侧穿支更强。
