Clark C P, Rohrich R J, Copit S, Pittman C E, Robinson J
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Plast Reconstr Surg. 1997 Feb;99(2):400-4. doi: 10.1097/00006534-199702000-00014.
The anatomy of the internal mammary vessels is poorly understood and thought to be unreliable clinically for use as a recipient vein in free-tissue-transfer breast reconstruction. This study of 10 fresh cadaver thoracic cavities demonstrated by anatomic and dye resection studies that the internal mammary veins become smaller (< or = 2 mm) distally (fourth rib) and bifurcate [left (90 percent) > right (40 percent)], becoming unsuitable for consistent venous anastomoses at or below the fourth interspace. Furthermore, this study suggests that the most consistent interval is the third rib, which offers an appropriate recipient vein (40 percent > or = 3 mm on the left and 70 percent > or = 3 mm on the right). However, at the fourth interspace, 20 percent of the cadaver specimens had a vein on one side that was 1 mm or less and therefore unsuitable as a recipient. This enhanced understanding of the anatomy (size, location, and consistency) of the internal mammary recipient veins offers our patients another recipient option to enhance the safety and technical ease of microvascular breast reconstruction.
人们对胸廓内血管的解剖结构了解甚少，并且认为在临床实践中，胸廓内血管作为游离组织移植乳房重建的受区静脉并不可靠。这项对10个新鲜尸体胸腔进行的研究通过解剖和染料切除研究表明，胸廓内静脉在远端（第四肋）会变细（≤2毫米）并发生分支[左侧（90%）>右侧（40%）]，在第四肋间间隙及以下部位不适合进行稳定的静脉吻合。此外，该研究表明，最稳定的间隙是第三肋，此处可提供合适的受区静脉（左侧40%≥3毫米，右侧70%≥3毫米）。然而，在第四肋间间隙，20%的尸体标本一侧的静脉直径为1毫米或更小，因此不适合作为受区。对胸廓内受区静脉解剖结构（大小、位置和稳定性）的进一步了解，为我们的患者提供了另一种受区选择，以提高微血管乳房重建的安全性和技术便利性。
