Shanahan D, Jordan R K, Coulthard A, Cooper P N, Varma J
Anatomy and Clinical Skills Centre, Medical School, University of Newcastle, UK.
J Anat. 1997 Apr;190 ( Pt 3)(Pt 3):467-72. doi: 10.1046/j.1469-7580.1997.19030467.x.
We have previously shown that the neurovascular anatomy and length of the long head of biceps femoris (LHBF) is suitable for its possible use in the creation of a dynamic perianal myoplasty to restore faecal continence. If intramuscular arterioarterial anastomoses exist between a muscle's vascular pedicles then the delay procedure, i.e. ligating the vascular pedicles to the transposed section of the muscle, 4-6 wk before transposition, can be used to improve blood flow to the distal part of the transposed muscle. The intramuscular arterial anatomy of 20 biceps femoris muscles was shown by dissection (14) or radiographically (6). The mean entry point of the upper major vascular pedicle to the LHBF was 12 cm (S.D. 3.3) and the mean length of the LHBF was 36.8 cm (S.D. 1.8). Therefore the ratio between upper major vascular pedicle entry point and muscle length in 95% of specimens was 0.33 (0.2). In the present study intramuscular arterioarterial anastomoses were found between the arterial pedicles to the nontransposed and transposed sections of the LHBF and between the long and short heads of this muscle. Using the delay procedure would therefore theoretically allow the intramuscular arterioarterial anastomoses between the arterial pedicle to the nontransposed and transposed sections of the LHBF to open up enhancing blood flow to the distal part of the myoplasty.
我们之前已经表明，股二头肌长头（LHBF）的神经血管解剖结构和长度适合于在创建动态肛周肌成形术以恢复大便失禁中可能的应用。如果肌肉的血管蒂之间存在肌内动脉-动脉吻合，则延迟手术，即在转位前4-6周结扎转位肌肉部分的血管蒂，可用于改善转位肌肉远端的血流。通过解剖（14例）或影像学检查（6例）显示了20个股二头肌的肌内动脉解剖结构。LHBF上主要血管蒂的平均进入点为12 cm（标准差3.3），LHBF的平均长度为36.8 cm（标准差1.8）。因此，在95%的标本中，上主要血管蒂进入点与肌肉长度的比值为0.33（0.2）。在本研究中，发现LHBF未转位和转位部分的动脉蒂之间以及该肌肉的长头和短头之间存在肌内动脉-动脉吻合。因此，从理论上讲，使用延迟手术可使LHBF未转位和转位部分的动脉蒂之间的肌内动脉-动脉吻合开放，从而增加肌成形术远端的血流。
