Kaddoura I L, Hashim H, Kayle D, Shabb B
Department of Surgery, American University Medical Center, Beirut, Lebanon.
Ann Plast Surg. 1998 Jun;40(6):655-8. doi: 10.1097/00000637-199806000-00015.
Thorascopic harvesting of the internal mammary artery for supercharging the rectus abdominis pedicled flap for breast reconstruction is presented. The procedure was carried on a woman who had previously undergone a mastectomy and who was obese and a diabetic. The patient underwent a "high" flap delay 2 weeks earlier. At the time of operative transfer and setting, the flap's vascularity was found to be compromised. Instead of turbocharging the deep inferior epigastric pedicle to the irradiated axillary vessels, it was possible to harvest and utilize the internal mammary artery without rib resection for the supercharging, thus saving the flap and reconstruction. The technical aspects, and possible advantages and disadvantages of such a procedure are discussed.
本文介绍了胸腔镜下获取胸廓内动脉以增强腹直肌带蒂皮瓣用于乳房重建的方法。该手术在一名曾接受乳房切除术、肥胖且患有糖尿病的女性患者身上进行。患者在两周前接受了“高位”皮瓣延迟术。在手术转移和安置时，发现皮瓣的血供受损。由于无法将腹壁下深蒂与受照射的腋窝血管进行血管吻合，因此可以在不切除肋骨的情况下获取并利用胸廓内动脉进行增强，从而挽救了皮瓣并完成了重建。文中讨论了该手术的技术要点以及可能的优缺点。
